He could be a podiatrist...

I remember a call with a cardiac pt, her son showed up and we explained-- in layman's terms-- what was happening. He goes, "I'm a doctor, just tell me what's up." So, we show him the 12-lead EKG and say "check out the elevations in five & six". Right away he goes, "um, I'm a actually a psychologist, sorry."

Back to the tourniquet issue... I can't speak for what a PA or MD would do, but current practice (for arterial bleeding) is direct pressure and then straight to tourniquet if that doesn't work. I could care less what Silver thinks of EMT/paramedics-- if someone gets shot outside of an ER, then it's prehospital and therefore our turf. Not trying to start a pissing contest here, but being a good ER doc doesn't necessarily translate to providing good prehospital care. What the average Joe at Koko Head will have in his IFAK is closer to what we carry on the rig, and any advice that any HM/68W/MICT has to offer is completely relevant. 

I can't tell you the number of calls where I'd have some person come up and say "I'm a doctor" and start giving orders. Occasionally, it would be someone with some relevant experience, but I always found that it was those guys that "offered" to help rather than tried to commandeer the scene. Most of the folks that tried that were completely out of their element (optometrist, third year medical resident, dermatologist, etc.). I'd usually tell them we were alright and operating off our protocols, but with the extra pushy ones I'd simply ask for their name and proof of professional licensure, and then explain that they could, if they wanted, assume full and complete responsibility for the scene, including associated liability if they wanted. None ever took me up on the offer. I have even had the cops remove these self-professed "doctors" from the scene for me if they continued to be a PIA. I love it when you watch them drug away by the cops screaming "...but I'm a doctor...."

As for his grammar and syntax, that and his completely dated advice pegged him immediately as someone who didn't have the background he claimed....hey, maybe he can be our very own version of the mall ninja. You know, the ninja doc.....wonder when he'll start advocating for intra-cardiac epinephrine and massive bicarb administration for arrests?

Yup, the offer of "transferring care" to them usually makes them leave. Years ago I had a code at Arizona Memorial, and this Italian woman kept hovering around, stating that she was a doctor and that she could intubate the pt for us. I was on internship then and there was no way in Hell I was going to give up a tube and miss my criteria!

wonder when he'll start advocating for intra-cardiac epinephrine... for arrests

Reminds me of that scene from Pulp Fiction. We just got these epi preloads in (the Luer-Jet ones), and for whatever reason, they come with this huge (like spinal tap) needle at the end. Showed my friend, and he asked if that was for drug overdoses, like Uma Thurman's character. He's not a medical guy... I told them they were prostate injections.

We just got these epi preloads in (the Luer-Jet ones), and for whatever reason, they come with this huge (like spinal tap) needle at the end. Showed my friend, and he asked if that was for drug overdoses, like Uma Thurman's character. He's not a medical guy... I told them they were prostate injections.

Yep, I remember those well. Those are the 3.5 inch intra-cardiac needles.....Those were in vogue back when I first started. Actually did many, many IC epi's during codes. That and Isuprel drips.....

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Which TQs are you guys carrying?

Picked up a few CATs from Mojo Tactical (thanks, Dave!).

For those who carry CATs, do you guys have them prepared for one-handed or two-handed application?

CATs, but you have to be careful. The market is full of knock-offs made in China and they are poorly constructed.

You should carry the CAT with a single routing of the end through the friction adapter (one handed set-up) so that YOU can apply to YOUR upper extremity. If you are applying to YOUR lower extremity, or to someone else's upper or lower extremity, you will need to loop the end through both slots of the friction adapter.

A good review of the CAT and other tourniquets: