YOUR TOURNIQUET IS NOT A SYSTEM. Are You Pretending To Be Prepared?

 

  

By Jonathan Willis

    It's easy to feel like you've "checked the box" by carrying a tourniquet. I see it all the time. Someone straps one on their kit or throws it into their glove box, and suddenly the feel squared away for trauma response. Here's the reality: YOUR TOURNIQUET IS NOT A SYSTEM! And a system is what you want.  A tourniquet solves exactly one problem - uncontrolled extremity hemorrhage. Yes, that problem can kill quickly, it is far from the only life threatening bleed, or lethal trauma related injury you should leave your home prepared to deal with on a daily basis. DO NOT forget, you are 8X more likely to be party to a significant traumatic injury that a violent conflict. Does your training, or daily carry, reflect that reality?

The Limits of the Tourniquet

Let's be blunt: if you carry only a tourniquet, you are wrong. You are not prepared. Why? Because obviously, the body doesn't just bleed from the arms and legs. And remember, the vast majority of significant bleeds from the arms and legs DO NOT require a tourniquet. 

Let's discuss the injury patterns that you must be prepared to deal with at a moments notice that with only a tourniquet, you have found yourself "behind the power curve."

- Juntional Hemorrhage - This is massive bleeding, generally arterial stemming from insults to the great vessels located in the neck, axilla (armpits), or groin. Areas that you cannot obviously tourniquet. These wounds require aggressive packing, pressure (3 minutes with hemostatic gauze, 5 minutes with non-hemostatic), and follow on dressing. 

-  Large Venous Wounds - These wounds are often "distracting" or graphic in their presentation and if not addressed can be quite problematic. But again, don't need a tourniquet. They need dressed or packed. Then wrapped. I personally carry gauze and a ESMARK pressure wrap to create the desired pressure dressing, but I very much love the ETD (Emergency Trauma Dressing) from North American Rescue to achieve the same outcome. 

- Chest Wall Injuries - Tension Pnuemothorax is the second leading cause of treatable traumatic death in the United States. As such, a chest seal, or the ability to immediately improvise one is VITAL. In my full kits and ankle kit, I carry the Hyfin vented twin pack. In a pocket kit concept, I carry a single NON-vented Beacon Chest Seal, the smallest seal on the market today. Beyond that, I'll improvise. 

As you can see from the three common injury patterns above, you must get beyond the tourniquet. 

What is a System?

    A system means that you've thought through the full problem set and built overlapping layers of skill, equipment, and access. 

- Tools - This can vary widely, BUT you should come as close to possible as ALWAYS being able to meet every aspect of the MARCH acronym. The least I ever have on my person is a CAT, gauze, pressure wrap, and a Beacon chest seal carried in a special pocket pouch of my own design. (Stay tuned for more info on the RWT Pocket Kit) Most of these items and their wrappers can do more than they were designed for. In winter, my ankle kit from Ryker Nylon Gear is more robust. 

- Training - Get REAL training. Obviously I'm partial to a certain course called Real World Trauma, BUT my friends Greg Ellifritz, and the whole Tactical Anatomy Summit crew are doing amazing work to empower people as they always have in this realm. 

- Redundancy - "Two is one, One is none." Now, those of us with decades of experience and training have a different presentation of redundancy than folks newer to the skillset. That's fine. As you learn, and God forbid experience more, your ability to improvise expands. When you're starting out, your "redundancy" might literally be two of a thing, until you learn how to improvise with "materials of opportunity." Until that time build out redundancy in your systems to meet the needs of yourself, your family, and others as your world dictates. 

- Context and Judgement - This is related to training, but still vitally important. Do you truly know the when's and when not's, the why's and why not's of these skills. Tourniquet vs. packing or dressing? Chest seal? Burp it, yes or no? What did I even just say? The gear without the true knowledge is just a talisman. 

Prepared Vs. Equipped

    The dangerous myth is thinking carrying an item makes one prepared. It does not. You are simply, equipped. And equipped, in the absence of preparedness, is meaningless. It's carrying a gun without ever having practiced target discrimination, reloads, marksmanship, or use of force law. Preparedness means recognizing the range of threats and having both the gear and the competence to handle them. That begins with, and expands rapidly outward from, the simple tourniquet. 

The Bottom Line

If prior to today, you carried only a tourniquet, you have been left exposed to some of the most common deadly injuries that you or your love ones could encounter. You can change the outcome today by making a simple choice. Preparedness is bigger than one tool. Make the commitment to building the skills, staging the gear, and being ahead of the problem that you know you're capable of solving.