so i have a question-
how many on this board carry a first aid kit or even an IFAK at the range?
and would you use it on a stranger?

me personally, i have an IFAK supplemented with extra anti-coagulants in my range bag
i'm not a real doctor, but i would use it if i had to on a stranger

aloha

steve

I don't carry a 1st Aid/Trauma kit...........my friend does sometimes.

I haven't had any training in clotting agents, so personally I'd never use it on someone I didn't know personally and even then only if they wanted to use it.

sorry
it was pointed out tome that i said anti-coagulants
i meant coagulants
eg- quik-clot, etc

aloha

steve

so i have a question-
how many on this board carry a first aid kit or even an IFAK at the range?
and would you use it on a stranger?

me personally, i have an IFAK supplemented with extra anti-coagulants in my range bag
i'm not a real doctor, but i would use it if i had to on a stranger

aloha

steve

When I'm at work I keep one I'm my bag and when I go hiking I bring one along too. Just a basic one from red cross.
When I took first aid from red cross we never learned tourniquets. She said its not needed and extremely dangerous. When I took the wilderness and first aid training they taught us how to do it. I guess a lot depends on how advance of the class is.

I also want to expand my kits. Where do you guys buy your gear from?

In my SUV I have a C-collar, a  couple pressure bandages, a SAM splint, compressed gauze,a sharpie  pen,  and an IV kit. It all fits in a gallon ziploc. And Yes if i'm the first on the scene i'm gonna start working on them.

Direct pressure is definitely the way to go.  Anyone in the military is going to endorse the tourniquet because the whole point of combat medicine is to get good guys back into the fight as fast as possible.  While bullets are flying, you can't have a few guys surrounding a patient giving direct pressure and elevating limbs in the open.  It's much better to have a guy throw a tourniquet on himself or have a buddy assist, and have one or two guns out of the fight for <30 seconds or so.  Personally, if it was ME somehow injured at the range, I'd throw a tourniquet on myself.  I'm less than 30 minutes from a good medical facility here, so I'm definitely below the 6 hour amount of time where I'd start to risk losing a limb.

Direct pressure is definitely the way to go.  Anyone in the military is going to endorse the tourniquet because the whole point of combat medicine is to get good guys back into the fight as fast as possible.  While bullets are flying, you can't have a few guys surrounding a patient giving direct pressure and elevating limbs in the open.  It's much better to have a guy throw a tourniquet on himself or have a buddy assist, and have one or two guns out of the fight for <30 seconds or so.  Personally, if it was ME somehow injured at the range, I'd throw a tourniquet on myself.  I'm less than 30 minutes from a good medical facility here, so I'm definitely below the 6 hour amount of time where I'd start to risk losing a limb.

Your training for tourniquets goes way beyond what is (not) taught in 1st Aid/CPR courses.  Tourniquets are just not taught.

Direct pressure is definitely the way to go.  Anyone in the military is going to endorse the tourniquet because the whole point of combat medicine is to get good guys back into the fight as fast as possible.  While bullets are flying, you can't have a few guys surrounding a patient giving direct pressure and elevating limbs in the open.  It's much better to have a guy throw a tourniquet on himself or have a buddy assist, and have one or two guns out of the fight for <30 seconds or so.  Personally, if it was ME somehow injured at the range, I'd throw a tourniquet on myself.  I'm less than 30 minutes from a good medical facility here, so I'm definitely below the 6 hour amount of time where I'd start to risk losing a limb.

If you are at the range and within 30 minutes of advanced care, why forgo direct pressure and move immediately to a tourniquet? Direct pressure is frequently effective, you don't have to worry about "bullets flying" or getting back into the fight.....and the 6 hour limit for tourniquet is not some magic number...cellular damage due to tissue ischemia (lack of oxygen) starts almost immediately on application of the tourniquet. Why risk it?

That type of thinking is why "cookbook" medicine can be problematic to teach....it removes some of the critical thinking behind the process of weighing the risks versus the benefits of treatment options. I'm not saying a tourniquet would never be the right answer in the situation of a GSW or traumatic amputation in the urban setting where medical care is close at hand, it just wouldn't be my first choice.

Oh, and my car kit has IVs, bulky dressings, SAM splints, CAT, and hemostatic agents....and gloves.....used to carry meds but got expensive replacing them. And I have been first at many scenes, and yes I start treatment. I also have an extensive background in emergency medicine and carry a million dollars in malpractice insurance....When EMS shows up, I can usually get them to replace my stuff, especially the IV fluids, tubing, and IV catheters.

i bought my IFAK from chinook medical
got clotting stuff from amazon.com
i think you should be able to get the one-handed tourniquets from amazon too

aloha

steve

When I'm at work I keep one I'm my bag and when I go hiking I bring one along too. Just a basic one from red cross.
When I took first aid from red cross we never learned tourniquets. She said its not needed and extremely dangerous. When I took the wilderness and first aid training they taught us how to do it. I guess a lot depends on how advance of the class is.

I also want to expand my kits. Where do you guys buy your gear from?

If you are at the range and within 30 minutes of advanced care, why forgo direct pressure and move immediately to a tourniquet? Direct pressure is frequently effective, you don't have to worry about "bullets flying" or getting back into the fight.....and the 6 hour limit for tourniquet is not some magic number...cellular damage due to tissue ischemia (lack of oxygen) starts almost immediately on application of the tourniquet. Why risk it?

That type of thinking is why "cookbook" medicine can be problematic to teach....it removes some of the critical thinking behind the process of weighing the risks versus the benefits of treatment options. I'm not saying a tourniquet would never be the right answer in the situation of a GSW or traumatic amputation in the urban setting where medical care is close at hand, it just wouldn't be my first choice....................

Pretty much sums up why tourniquets are not taught in 1st Aid/CPR.........

The short answer.....

Conscious injured person: I'd explain the dangers of not letting me help you, and wait for a yes or no.

Unconscious: Yes, no questions asked.

The short answer.....

Conscious injured person: I'd explain the dangers of not letting me help you, and wait for a yes or no.

Unconscious: Yes, no questions asked.

Implied consent works with the CPR thing and I guess is arguable if you've had training with a tourniquet.  If you do not have training, then Good Samaritan will not cover you.

so i have a question-
how many on this board carry a first aid kit or even an IFAK at the range?
and would you use it on a stranger?

me personally, i have an IFAK supplemented with extra anti-coagulants in my range bag
i'm not a real doctor, but i would use it if i had to on a stranger

aloha

steve

I have all the standard gun wound care stuff in my bag.  I do need to get some sheers though.   I would not hesitate, one minute, to put a TQ on someone.

just got this email from chinook medical that is appropriate to this discussion:

I want to apologize and correct for a proofreading error published in our company newsletter yesterday regarding the use of tourniquets. We shared a WebMD quiz with you that recommended against the use of tourniquets for wound care in the home, and I want to address our position around this subject.

This statement contradicts current EMS protocol which advocates for the use of tourniquets for life threatening extremity hemorrhage that cannot be controlled by other means. When used properly, the tourniquet is a proven life-saving device used to control traumatic and severe bleeding when applying direct pressure and hemostatic bandages fail.

aloha

steve

i bought my IFAK from chinook medical
got clotting stuff from amazon.com
i think you should be able to get the one-handed tourniquets from amazon too

aloha

steve

I have all the standard gun wound care stuff in my bag.  I do need to get some sheers though.   I would not hesitate, one minute, to put a TQ on someone.

I have a few extras, remind me and I'll give you one. As for hesitating to use a tourniquet, as before, in a battlefield situation, don't hesitate. If, however, you are close to medical care, one could argue, successfully IMHO, that not using direct pressure and hemostatics (if available) would be negligence. Add to that any real or perceived vascular or nerve damage from the tourniquet, and you might find yourself on the wrong side of a legal action without the benefit of any good Samaritan protections.

Currently American Red Cross does not teach tourniquet use, however American Heart Association, American Safety & Health Institute, and Emergency Care & Safety Institute all support their use and train how to properly use them in desperate situations in their First Aid and Advanced First Aid, and Wilderness First Aid classes.

Tourniquets should not remain in place longer than 10 minutes at a time.  If the source of the bleeding cannot immediately be identified and ligated, the tourniquet should be loosened momentarily every 10 minutes.

Tourniquets should not remain in place longer than 10 minutes at a time.  If the source of the bleeding cannot immediately be identified and ligated, the tourniquet should be loosened momentarily every 10 minutes.

Ehhhhhhhhhhhhhhhh...Personally, if it was MY leg squirting ARTERIAL bleeding, I'm gonna crank that bitch down, and I'm fine with keeping it there for a couple hours till I can get CASEVAC'd to a medical facility.  Definitely not loosening a tourniquet over an arterial wound after 10 minutes.

Ehhhhhhhhhhhhhhhh...Personally, if it was MY leg squirting ARTERIAL bleeding, I'm gonna crank that bitch down, and I'm fine with keeping it there for a couple hours till I can get CASEVAC'd to a medical facility.  Definitely not loosening a tourniquet over an arterial wound after 10 minutes.

if you wanna keep that limb you will.  I'm not saying to let yourself bleed out but you gotta loosen it for just a bit every 10 mins or that limb is gonna die.  after about 5 mins and some muscle will start to die.  longer then 10 mins and your gonna lose that limb!

if you wanna keep that limb you will.  I'm not saying to let yourself bleed out but you gotta loosen it for just a bit every 10 mins or that limb is gonna die.  after about 5 mins and some muscle will start to die.  longer then 10 mins and your gonna lose that limb!

Guys blown up in Iraq and Afghanistan have tourniquets on for over an hour and keep the limb.  I go by my training and experience.

Granted, it's not Iraq or Afghanistan, but we have amazing hospitals here and I don't have to wait an hour for a helicopter to pick me up.  I have full faith in doc patching me up.

Tourniquets should not remain in place longer than 10 minutes at a time.  If the source of the bleeding cannot immediately be identified and ligated, the tourniquet should be loosened momentarily every 10 minutes.

Disagree. Please identify your source of information as I believe it is probably dated and not standard of care.