Stop The Bleed: Tourniquet Application
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- Опубліковано 17 сер 2024
- A detailed look at using a tourniquet for bleeding control. In this video a North American Rescue Combat Application Tourniquet (NAR CAT) is used as an example.
Want to skip right to the application of the CAT? 04:54
CAT: www.narescue.c...
SOFT-T: www.tacmedsolu...
Drum sample music credit: audiojungle.ne...
Great video! One thing I do to ensure tourniquets aren't overlooked is to take my Sharpie and write a "T" on their forehead, the time applied, and the location. LA= left arm, RA=right arm, LL=left leg, RL= right leg. Every care provider that comes into contact with that patient will see the markings on their forehead when they check the airway, and know to look for a tourniquet. Keep up the great work!
Location should be a little obvious
lmfao, this is brilliant
@@sethambre3001 if you're not using a bright orange Tourniquet and the victim's clothing blends in with the Tourniquet it may be difficult to notice it right away, I own black Tourniquets for instance. Just food for thought.
@@jordanpeterson1893 If you have to use a TQ I am sure they will see the blood or wound itself and guess "Ooh. That's the TQ.."
@@barsdogukankarakoyun8798 Very easy to miss a tourniquet if the patient is wrapped in a blanket - there is zero harm in a T on the forehead to make it very obvious. Situations where receiving a PT with a tourniquet applied are likely to be extremely stressful and removing or reducing any risk of missing something key is not a bad thing
Absolutely tourniquets can be placed on the lower leg and forearm but high and tight shouldn't be dismissed. High and tight makes it easier for most people to remember under stress. Also, high and tights will be fine if you are not far away from definitive help. Tourniquets can be safe 8+hours if applied correctly. Going 2 to 3 inches above isn't bad and neither is going high and tight. If the tourniquet is place effectively, that means no venous and no arterial blood flow is present then the risk of compartment syndrome is low. Remember, if you place the tourniquet properly it will hurt more than the wound. Good training is key here. There are many tourniquet trainers you can buy to practice with. Good video. Everyone stay safe!
Thank you for the like on the comment!!
Your reply has solid info! Great job.
That, and arteries are like elastic bands. They can retract up the extremity above the wound and you may not place the TQ high enough to occlude blood flow.
"it will hurt more than the wound" ugh I just remembered what it feels like. Another forgotten memory from my conscription service bootcamp resurfaced.
High and tight because pressure plates blow shrapnel up into the body. Two inches above a stump is useless when the metal shredded the leg up to the middle of a femur
I Have no idea how i got to your channel but i love it
Same Lol
Even a year later, this is still happening
Did u call 9-1-1 for a severe artery bleed cause I hear they use your data for ad revenue
Greetings from Germany,
Im a paramedic student in Germany and i recently found your channel. And i must say, your videos are easy to follow and great for learning .
Its Awesome to see that standard Procedures for some things are the same .
Keep up the good work
Even more greetings from Germany! I'm a med student, planning to go into ambulance duty as well (in Germany we have so called emergency physicians to support the ambulance crews). Overall, I can agree with Kevin that procedures, equipment, medications etc. are quite similar, even though they are organized in a different pattern. For example, almost all of the meds and insturments are stowed in drawers in the front of the patient compartment, only the suction, the monitors and ventilation and additional tools and stretchers are somewhere else on the vehicle. Many German ambulances (if not the majority) do not use external storage compartments. To go to the patient, we carry emergency backpacks (or more traditionally emergency cases), which contain both meds and instruments (but there are more meds stored in the ambulance). Usually it's that pack and a monitor/defi that is carried (Kevin, correct me if I'm wrong, I am not yet actually in the ambulance service). In Germany everything is standardized and so weird ideas such as a separate medication case are not allowed. In regards to narcotics I'm not enitrely sure how this is handled, but a lot of those can only be administered by, or by order of an emergency physician.
I didn't like my "notfall" experience in Germany and, thinking of it later, I find it REALLY unusual that they "couldn't find anyone who knows English so they could talk" to me. I didn't know a single bit of German then (except what I knew from when my dad I didn't know for long spoke it in the 70s and almost nothing is the same now) but for some reason they wanted someone who spoke fluent English and for some other unknown reason couldn't find anyone.Considering all the people I'm finding NOW who know English, I'm still bothered that they couldn't find anyone that night. I was more upset than I've ever been & probably the worst patient on earth and since I was a visitor I didn't have insurance.
In 7 years I will have my Notarzt qualification, I'll tell you where to come for your next medizinischen Notfall in Germany, so you can have a chat with us :P
Though you must have been really unlucky, English is compulsory in most German schools from year 3 on. Most Germans speak English... not good English but sufficient to converse with a patient during an emergency.
Def7355608 It won't matter now. I'm in A1.2 German, taking official courses bc self-learning didn't work for me. German now isn't the same as in the late 1930's when my dad was taken out of the country and adopted by a family living in America. My dad would be positively shocked to see German of today. They don't even use the word 'Apfelsine' anymore. Now they call it an orange.
@@VickiBee Actually, we do use Apfelsine exactly the same as we have for the last century... however some phrases have fallen out of use, and everyday conversations are often not very diverse in grammatical structures as they were a century ago.
As a Prepper, and a Paramedic myself, thank you for such a detailed instructional video of how to properly use a CAT.
I needed a refresher on this. Thanks. Also, I carry a Sharpie in my kit so if I ever administer a tourniquet I can write the time on the CAT as well as on the patient somewhere visible and write a large T on the forehead.
Something that should be considered when determining the placement of a tourniquet is the MOI (mechanism of injury), for instance, a bullet from an active shooter. The reasoning behind the military teaching the "high and tight" placement for tourniquet application is to account for bullet trajectory. Bullets do not always enter the body from straight on. Depending on the round caliber, distance traveled, whether the round is entering the body as a ricochet or fragment may affect the route the bullet takes and the damage it causes. A round may enter the forearm or flexor muscle and the trajectory may take it upward and back to the bicep and could hit the brachial artery. By placing the tourniquet above the visible wound could cause unnecessary damage, especially once you start entering the prolonged field care stage.
Retired after 52 years in healthcare beginning as a Navy Corpsman in the 60s. Still carry the Unit One in the car, but its contents have changed since FMSS-all for the better. I like to keep up, and PrepMedic is a great refresher. Thanks for what you do.
For an EMT that took class online, this is literally saving lives
I've always carried first aid basics, but never felt comfortable with tourniquets until I watched this video. I'm not a medical professional but I take first aid seriously. I am out in the woods quite often, I work in the field driving around a lot and I began carrying quick clot gauze and an Israeli bandage in my kit in addition to the usual first aid stuff. I have a decent understanding of cpr and SOME bleed stopping procedures. I decided to order one of these CAT tourniquets just in case after watching this. Given the climate of the world and the US in particular it would seem foolish NOT to be at least a little more prepared. I'm no armchair medic, but having the basics on hand has been drummed into my head over the years just in case. I appreciate your advice and recommendations, keeping it simple enough for the layman to understand helps a lot.
Writting in the patients forehead is also an great way to show he is using an touniquet. Saw in some old first aid manuals you should loosen up the touniquet every 15 minutes to check if the bleeding stopped.
That third variant of TQ is for femoral bleeds. You wrap it on the pelvis and put a plastic thing under the artery and pump it up like a baloon, cutting off bloodflow to the rest of the leg. Its incredibly effective and since the pelvis is so high there generally is no other way to use a TQ
I'm pretty sure that Both American Rescue makes a pelvic sling for that .
Great stuff, no lengthy intros, no blah blah, clear and valuable information - left a sub
Hey, just wanted to say as a person in EMS your videos/playlist made me feel much more confident in my skills. I went through a bunch of them already.
Thanks for your easy to follow, straight to the point videos. Keep up the good work!
Many, many thanks, ALL THE LOVE from the UK.
Awesome information bro and love the integrity and not being a sell out that's absolutely fantastic because 100% correct no amount of money if worth loosing a life keep up the awesome work here bud
I am very happy to hear that you won’t talk highly of a product just for money. I love love love you’re channel so much and you yourself are an inspiration. Thank you for your time
Great, concise, easy to understand instructions. Just what I hoped to find. Nice video.
Stop The Bleed has only been recently introduced here in Canada. I took it at Sunnybrook Health Sciences Centre earlier in the year - Canada's largest trauma centre, and the instructors recommended the CAT-T. There have been a couple of terrorist attacks in Ontario this year. Having the training, a small cargo pocket sized trauma kit and a CAT-T go with me everywhere now. Looking forward to more videos. (found you as a recommended off one of Skinny Medic's videos)
A great tip if you’re caring for several people in a combat situation, have each of you guys carry a tourniquet in their right arm pouch and left leg pouch and have them prepped for self application. Also in a dangerous situation you can always kneel directly on the junction space until it is applied (unless it’s a fall or blast injury and you suspect a pelvic fracture).
Sad any one would dislike any of his videos, I have learned a lot just watching these videos.
Thanks for the excellent video. I am just a normie (with advanced first aid training) and my kids are into extreme sports. I run a chainsaw from time to time and my whole family and I drive a lot. I want to be able to be effective those first 10-15 minutes. A decade ago I came across an overturned vehicle in the middle of nowhere and there was entrapment with serious injuries. I’m glad I was prepared to handle it - EMS took 20 minutes to arrive. Next time I want to be even better prepared.
Great period of instruction. Used it to refresh myself to teach tourniquet application to a civilian audience
outstanding. Thank you for sharing your knowledge. I have incorporated a CAT in my range bag.
This is definitely something every outdoorsman should have in their kit. Could you do a video on blood clotting gauzes for civilians as well? I’m thinking about hunting, accidental gunshot wounds, knife cuts or chainsaw wounds. Cheers.
I found your channel trying to get my car & home First Aid kit together, thanks for the info I will certainly order a TQ to add in my kit. 👍
Excellent "On-Balls" information. Professionally executed. Thank you, PrepMedic. Liked and subbed.
Great videos! I am so glad I found your channel. Keep up the good work!
extremely helpful. i'd encourage you to keep going with this fantastic videos
Thanks, great refresher along with your folding video.
Man your channel is just exploding! I subbed at like 80-100 subs and look how many followers you are gaining daily now!! Keep going and nice vid as always!
@@PrepMedic If you keep going like this it's going to be 50k by the end of the year :D
UA-cam actually recommended me something good for once. Usually it’s make up tutorials. Finally they’re learning
06:18 Dude, that noise was straight-up terrible. I about had a heart attack!
I’m glad someone said it, I thought it was coming from outside
ᴬᵘᵈᶦᵒʲᵘⁿᵍˡᵉ
Thank for the info. I didn't even know what a tourniquet was, again thanks a lot.
our class on this was vague ...my exam on Monday i will ace it now. i subscribed. found you just looking for info on -stop the bleed
Thanks for your posting and you are one of the best. Keep it simple is the best way
Great video. Just the facts.
I bought a CAT-type tourniquet from an online mail-order company for only $3.98 and the included instructions, plus step-by-step photos, were both confusing and poor quality, respectively. The item itself was high quality.
Your video helped a lot to figure out how to use it. Keeping the tourniquet in my emergency first-aid kit of my vehicle and to bring with on outdoor adventures.
Hey man. Those counterfeit TQs are incredibly dangerous. Throw it out and buy a real one.
@@PrepMedic Not throwing away something that isn't defective. Or, just because I got it at below wholesale prices. Price or cost is not a fool-proof indicator of quality. You could over pay for one, if that makes you feel more comfortable. It can only be a 'counterfeit' if it pretends to be a particular brand. It does not. (I would take a picture of it and attach it to this post, if UA-cam made it possible, for all to see.) Viewers should be asking, 'Where did you get yours?'.
@@pvt.2426 Its a counterfeit CAT TQ which have always came with HUGE defects that cause failure in a large percentage of cases. There are litteral studies about it and documented deaths due to them. I guarantee you 100% it is not a CAT TQ and you bought a cheap knockoff with no QC or durability standards. CAT TQs will NEVER be sold for under the $20 mark and yes the brand actually matters. This isn't simply my opinion. This is documented and backed up in so many places. Not only is it unethical to use knowing the failure rate but it is also less effective then just stuffing your shirt into someones wound.
@@PrepMedic I appreciate your sincere advice. This TQ is for my personal use and kept for emergencies that hopefully will never happen. I look at it as something that is better than nothing. If I happen to be in the right place at the wrong time and an injured person could benefit from this, I doubt that he or she will inquire or insist on a particular brand. If they do, then I'll walk away and let them bleed out.
@@pvt.2426please for the safety of you and others just buy a legitimate one
I never bought into the "it can cause an amputation" argument. I figure, which is worse? Bleeding out and dying in two minutes? Or taking a chance with a tourniquet? I'm glad to hear that after twenty years, the official standards have finally risen to mine.
Like the argument that aspiration during a Covid vaccination is unneccesary and in fact prohibited by trainers. After just one year of argument and "Pishta!" the establishment is finally figuring out, aspiration DOES prevent some deaths, and has no negative drawbacks.
Thank you PrepMedic, subscribed and thumbs up!
You and skinny medic deffintetly should do collaborations. I feel like with both of y'all knowlege it would he an awsome team and could teach alot to diffrent people.
Just found your channel I love the content! Keep the good videos coming!
TCCC has added more to the list...Ned to update info. There is now a 3" wide tq with a ratchet rather than a windlass.
Roger Dickinson watch some of my more recent videos. I have one discussing just that.
OK, thanks, I haven't seen it. I have one on order.
Wow, you grew about 1k subscribers within a week. Nice, you deserve 250k subs.
@@PrepMedic You need a patreon
Excellent video presentations, thank you.
Didn't answer my biggest question:
When I try to apply a CAT to my arm (which is, I'd say, average size for a 5'8" man), I notice that it takes more than 2 full wraps to consume all of the slack. By wrapping around twice, the strap covers the windlass, and the velcro is prevented from securely adhering... so obviously that's unacceptable; how I do get rid of the excess slack with only a single wrap around the arm?
Very nice explanation and tourniquet recommendation
I was told in bawic training to throw the tourniquet ad high up as possible no matter where the wound is, been three years since then and have been told the same thing since then
great content ! Thanks so much ! ... I love the audiojungle sample over the bg audio track Lol
Great Channel, going to use in some upcoming training I do.
Great videos. A wealth of information. 👍
I find ur videos really useful even though I’m watching them in the U.K. where not many people know first aid let alone knowing about catastrophic bleeding, tourniquets and wound packing 😉
Cheers mate!
I'm Spanish, and that's the same here!!!
I just ordered one SOFTT-W and an Israeli Bandage for my Bleeding Control Kit.
@@tspableras1731 I’ve got an orange CAT, Israeli bandage and some sterile gauze in my one
Great vid! Right to the point with no BS in between.
New subscriber here, I do what you do and I’m learning a lot here to pass on with my nurses. Keep it up!
Great video. Glad I found your channel
Great video! Very underrated channel full of great content!
Great Job! I shared this on FB!
Good Stuff, If I may make a suggestion perhaps for a future video you could do one on the use of hemostatic gauze and wound packing techniques
Awesome I look forward to seeing it.
Great video, new to channel. I have the same glasses. Thanks for all the information.
I just got a new TK of this model but I am a newbie and am trying to find a video showing how it's applied. Thanks so much for taking the time to make this video, but after watching it, I still don't know how to apply it. I would love to see a video that shows it being applied straight from staging. I would also like to know how to deploy it one-handed on myself.
solid informative video. Straight to the point!
I was taught to use a permanent marker to write "TQ- time" on the patient's forehead.
The way I was told is write TQ on the injured persons head so they know they have a TQ applied and we can chuck an emergency blanket. I am unsure how is it for you lot in the US, but in NZ that's the way we have been told.
Good practical demonstration. Thanks.
I love the quality of your videos!!!
This is great info but one thing when I was in the corps (infantry) we were taught to put the tq as high as possible on the limb no matter where the injury is because that severed artery will contract and it can go all the way up the limb and bleed internally so if you put the tq a few inches about the wound and there is no blood coming out that could be because you basically created a boloon like effect and the artey is high up in the limb filling it with blood
That is no longer standard of care. The only time a TQ is placed high is when the source of bleeding can’t be located rapidly
i also have the CAT in emergency orange...after doing some homework it just makes sense...
Most gun guys stray away from it because it’ll “give their position away” and it’s not tactical looking enough, but I think someone’s more likely to notice a man moving around holding a rifle with a mounted flashlight on top than a small orange TQ on your body. Plus orange makes sense for obvious reasons because it’s easier to find on your kit when you need it.
@@toddcarter156 apparently soldiers in Iraq and Afghanistan would often wear the tourniquet on themselves before going to combat so they just had to tighten it immidiatly after getting shot so in that case a dark color is useful
thanks for sharing
Best video ive seen - great job
Med student here. Firstly: One can use a simple 5 cm (2 in) bandage for that, too. Fold it half, put it around your arm and use the loop that is created to tighten it. Wrap the remaining bandage around your arm at the same point, then tie a knot. Finally, use anything long and hard for the tightening. Personally, I always carry a small first aid pack either in my backpack or on my belt and this way I don't need to waste space for a tourniquet which would only have this one use, whereas a bandage can be used as... well... a bandage.
In a surgical environment I have used a bandage and Kocher forceps successfully before, the Kocher being both the fastening clip and the tightening lever at the same time.
A tourniquet can also be used on lower extremities, since it raises the overall pressure in the tissue above the systolic blood pressure, thereby stopping the bleeding. The above mentioned surgery was a toe amputation after said toe was infested by a cancerous growth. The tumor, as these pesky things do, had grown some decent vessels to supply itself, so we had this contraption ready.
IMHO, I'm also a student and I think we need to separate those scenarios.
In a clinical setting, the 5cm bandage might be applicable. Though I'm not sure why you would use that. Phlebotomist have their own versions of tourniquets when they do their labs. You've probably seen some use (latex free) rubberized straps and tie the ends. Or nylon straps with either the clip-styled or velcro closures. They work, but those tourniquets are meant for short term use only in a clinical environment.
On the other hand, the Special Operations Forces Tactical Tourniquet (SOFT-T) and Combat Application Tourniquet (CAT) as their names suggest, are designed for combat, ie. use in austere environments.
CoTCCC looks at issues like: Will the service member (LE or military) be able to maintain positive pressure if that 5cm bandage is wet, exposed to mud, sand etc? Will a CAT or SOFT device stay in place if you have to drag a casualty across sand, mud, etc.?
Agreed.
Unfortunately the article you linked redirected me to a login page about a minute after I started reading. At least in the sections which I read, it did not suggest any possible reasons why that might be, neither did it mention the type of studies that were used to determine this. The result is brave enough that I would question both the quality of the study, as well as the interpretation, especially in emergency medicine, where one usually has to resort to study types that are more susceptible to bias (as we have seen with immobilisation).
It is of course plausible (and probable) that a commercially produced tourniquet, which is the result of sophisticated design and use of experience, will be more effective, though such vastly different results between two procedures using the exact same principle and exact same procedure do raise my skepticism.
Of course there is also a difference between clinical and preclinical use, though the success of an improvised tourniquet strongly suggests that the procedure itself is not the problem.
Nonetheless I highly value your input and I recognize that you are currently the more educated and more experienced of us in regards to emergency medicine.
As the old saying goes: "More research is needed to [...]"
I'm enjoying this conversation. It's refreshing to see intelligent discussions on UA-cam.Thanks guys.
Mr W Thanks for your compliment. I love the open conversation we can have here and I want to learn the most of it.
In the meantime, I have done some loose research and found excerpts out of such studies. "Although it is certainly possible to improvise an effective arterial tourniquet, the data suggest that this is uncommonly done appropriately, especially under stress." (King et al, the one analyzing the Boston Bombing).
I think this (at least partly) confirms my initial suspicion that "the success of an improvised tourniquet strongly suggests that the procedure itself is not the problem."
Overall, studies examining mortality always leave a bitter taste. You may just have supplied me with a topic for my doctorate thesis, a controlled trial of improvised and commercial tourniquets on cadavers. I'm sure the anatomy dept would lend me a few arms and legs which I could perfuse with simulated blood, give a defined injury and then try to apply a tourniquet.
Jeff Kirkham, inventor of RATS Tourniquet, has served 28 years with the US Army Special Forces (active and guard), with numerous operational deployments to worldwide posts in both semi-permissive and non permissive environments.He is currently a Master Sergeant (18Z) with the 19th SFG (A) and, in the past, was a Special Agent with the Drug Enforcement Administration (DEA).
Besides earning a Bachelor of Science from the University of New York and completing the Special Forces Weapons Sergeant Course, Jeff also graduated from: US Army Ranger School, Special Forces Combat Dive School, US Army Free-Fall School and numerous other shooting, driving and close-quarter combat schools.
In his spare time, Jeff is an inventor - with four utility patents issued and multiple others pending - an author of 2 books, a member of his local Free and Accepted Masonic Lodge, a supporter of the Boy Scouts of America and an avid Cross-fitter and marathon-runner.
Jeff is also a father, and his greatest joy is spending time with his family
I thought that rats is good for small arms and legs too?
Thanks for the info
Came here from 731 Woodworks. He was right, this video was great!
is good video Stop The Tournquet Application
Outstanding presentation !
Very helpful - thank you!
Next to direct pressure, a CAT is probably the easiest BLS practice there is. When I was trained in the 90s, tourniquets were oddly discouraged.
cue cutscene of a drill sgt screaming "high and tight!"
Thank You
Thank you, well presented
Yet another great video. Thank you
in the army CLS course they teach high and tight, and by tight they mean so tight you cant even try to stick a finger under the tourniquet. also instead of time they say to use the persons blood to write a T on their forehead. oh and they say to kneel on the limb while applying the tourniquet
So a couple things have changed in the military since you took CLS (or your CLS instructors were a bit behind). High and tight is only used if the source of bleeding can’t be immediately identified. Knee drops are harmful and are no longer taught.
Excellent reviews!!😃👍👍⭐️⭐️⭐️⭐️⭐️
Three thumps up. Good explained and easy to follow. Thanks for sharing
"audio jungle"
Army Infantry in the 80s, were were trained to beware of tourniquets and were discouraged from using them. Never even saw a tourniquet
That's insane.
Thank you. You are very helpful
Have you heard about the R.A.T.S torniquet? What do you think about it? Do you think that it really works? Would you recommend it?
I love your videos, really nice content. I'm preparing myself for a medical school. I want to be a paramedic since I was 8 years old
Why does this channel not have millions of subscribers? North American Rescue should be sponsoring you!
Question; I have only ever user the CAT on other people, so that’s what I EDC. But in talking with non 68W soldiers and LE personnel, the RAT is better for using on yourself. Do you (or anyone else) have experience with the RAT? Would you recommend it?
Thanks super helpful
Thanks. I needed that. Love that you did it over again. Also can you reuse a tourniquet?
Had a tourniquet applied for over an hour for a bicep laceration. Easily the worst pain I have ever felt. Nothing else comes even close.
Luckily I don't have any other serious injuries to compare it to though.
The pain from the tourniquet? Or the bicep laceration?
@@Jimmylad. ya know now that you say it, I'm not 100% sure. I'm basing it off of the stuff that they were saying at the time, like "this is gonna hurt" before they tightened it, or just general statements like "yeah, tourniquets are painful" after I stopped screaming lol.
Thanks
The person in my Paramedic Training called it a Tourni KAY. I always thought it was called tourniquet the way you pronounced it, not the French way. But since I was married to a French-American doctor at the time I was in Paramedic School, and I'd heard him pronounce it that way, I started doubting my own pronunciation. I was with that doctor for 18 yrs. He had a Ph.D in Medicinal Chemistry & Physics. Anyway, he pronounced words he thought were French in the French way. IDK if tourniquet was French but it sounds like it.
Thanks for this information
Thank you.
Cool stuff we just practiced this at work.
the advice we hear is to leave the tourniquet on until you reach the hospital, but what if you cannot access the hospital for multiple days? For example in combat with no evacuation available, or in the backcountry with a missing or malfunctioned radio and whistle, losing a limb could be a death sentence, it may be safer to remove it yourself. What would the procedure for that be? what is the proper procedure that the hospital uses?
Thank you!
Watching this video has settled it. I do not need a tourniquet when I go camping alone. An Israeli bandage maybe. But my med kit is good.
Carry one! I dont remember the exact numbers but studies has shown that more than 85% of the improvised tourniquets fail to stop the bleeding! The improvised ones are better than nothing, but definitely not enough!