https://www.trauma-news.com/2018/04/...-in-mortality/
Not NEW information but to the extent that you still have people who question the use of tourniquets, I can't think of a more authoritative source nor relevant study.
https://www.trauma-news.com/2018/04/...-in-mortality/
Not NEW information but to the extent that you still have people who question the use of tourniquets, I can't think of a more authoritative source nor relevant study.
Conventional trauma management is still behind the times, by about 5 years. The gold standard courses--ATLS for physicians, TNCC for nurses, and PHTLS for everyone else--still cling to the old ways. I am trying to change this in my institution, but it's largely jousting at windmills.
It is still largely driven by ABCDE instead of MARCH, still 2 large-bore IVs, it treats permissive hypotension as something to consider rather than the current doctrine. It's the nature of institutional medicine plus textbooks/curricula that hasn't caught up to research and current practice. It will in the next iteration, but it takes forever.
It seems some still cling to the belief that once you put a tourniquet on, the patient will loose the limb.
I still thought that until I got some training (Dark Angel) and got a new, updated perspective.
Any change in any industry is always time-consuming.
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It's really not; in fact, it (TQ) is actually safer. It's a whole paradigm shift in a way of thinking that is over 75 years old. As the current generation of providers age and move out, and the curriculum catches up, it will be good.
How's this to blow your mind: in my institution, only physicians--not nurses, not paramedics who work in the ED, not mid-level providers--can put on a tourniquet.
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Nice. I just started putting together a small IFAK, and this makes me feel slightly less silly in doing so. I've narrowed it down to tourniquet, combat gauze, chest seals, trauma shears, nasopharyngeal, and pneumothorax. If there's room left, I'll add an Israeli bandage and maybe a space blanket.
Nothing can replace gun safety courses with hands on instruction. If everyone would follow any one of the three safety rules at all times, accidents would be virtually nonexistent. Every accident is always without exception caused by a complete breakdown in all three categories. The system works when people learn it and practice it.
The standard Israeli does not have removable gauze for wound packing, just a non-adherent pad. The newer T3 varient does. It's an interesting product that combines several things in one package. https://persysmedical.com/products/h...ol/t3-bandage/
This is my next move also. I watched a video by Karl Erickson, Tactical Rifleman, who has medical training and experience. He made a big point of buying a tourniquet made in North America and not some cheap crap made in China for airsoft appearance purposes. So I intend to put together a kit from my local military surplus company.
Broblem being not everything needs a tq. Many injuries just need a pressure dressing and idiots throw a tq on it.
North American Rescue (CAT) and Tactical Medical Solutions (SOF-T) are probably the 'better' sources, but you can find reputable TQs from many vendors (to include Chinook Med, My Medic, and others).
Yes, like that moron in Kenosha....
This is often a contentious issue. An IFAK is to be used on YOU, by someone else. You might get a trauma surgeon, you might get Ricky Rescue who saw it on Youtube. The probability is more the latter and not the former. I do not advocate anyone use one if they have not been trained. Even if you have been trained, depending on state law, you may or may not be liable regardless of any Good Samaritan laws.
I will say, in 30 years (almost 31 now), I have never seen anyone die of a singular tension pneumo. TPs are usually accompanied by other things, and those other things are usually the cause of death.