Tourniquets to control bleeding has been in use for centuries, sometimes praised and sometimes reviled as a tool of the devil. Painful lessons learned in Iraq and Afghanistan, however, lead us to believe that they save lives that would otherwise be lost to hemorrhage. In civilian life, the rapid and effective use of a tourniquet by those at the scene gives valuable time for emergency medical personnel to arrive. In survival settings, it doesn’t take a rocket scientist to know having tourniquets in your medical kit is not a bad idea.
For years, the Committee on Tactical Combat Casualty Care (CoTCCC) has approved a small number of commercially available tourniquets, which I’m sure many of you have in your medical kits: They include the combat application tourniquet or CAT and the special operation forces tourniquet SOF-T.
These are the tourniquets you’ll find in our medical kits. We also add the non-TCCC SWAT tourniquet as a secondary tourniquet in many of them, mostly due to its versatility to also function as a pressure dressing and splint stabilizer.
Now, the TCCC committee has widened the range of options acceptable for the effective control of bleeding. One of their additions is the SAM-XT (pictured at top of page), produced by the venerable Dr. Sam Scheinberg of SAM medical. SAM is well-known for producing malleable splints useful for a number of orthopedic injuries, and now their tourniquet is considered acceptable for even military use…
Dr. Alton at Doom and Bloom Medicine has a short article and video dealing with Tactical Combat Casualty Care.
You may have heard me reference something called “TCCC” in previous articles, podcasts, or videos. TCCC, sometimes called T3C or T triple C, is a term that means Tactical Combat Casualty Care. It represents the recommendations with regards to prehospital care of soldiers who have incurred traumatic injuries on the battlefield. Established in the mid-1990s, TCCC guidelines have become so widely accepted that many law enforcement and civilian medical personnel have adopted them.
And well they should. These protocols were developed at the cost of painful lessons in the field in Iraq and Afghanistan. It is thought that there were 1000 preventable deaths in these conflicts. If you add civilian injuries during the same time period, the number of preventable deaths might number in the hundreds of thousands. The TCCC’s primary goals is to save lives, prevent additional casualties, and, in true military fashion, complete the mission…In survival settings, you can’t duplicate the care given at a field hospital or a trauma center. Your final outcomes won’t always be happy. You might, however, use some of the methods in MARCH/PAWS to possibly save the life of those who would otherwise die during or in the aftermath of a disaster…