A good medic takes pride in being able to make do with less. Emergency medicine almost never happens in a place when you have every resource at your disposal.
Unless you’re shot in a hospital, odds are good you’ll be severely limited in the type of gear you need to save a life.
Bleeding control is of course the most time sensitive issue for any trauma. Bleeding must be stopped at the earliest opportunity or the casualty may not recover from serious wounds.
Fortunately, bad extremity bleeds are relatively simple to control with the right tools. Tourniquets (TQ) enjoy a good track record for saving lives because they are quick and easy to apply and anyone can learn how to do it effectively in a short time.
But if you don’t have the right tools for the job, survival rates start to drop significantly. Since tourniquets appear to be very simple devices, sometimes it’s assumed you can just quickly make one on the spot and save the day.
But since this is Real Life, things don’t always work like it seems they should.
Your first choice should NOT be to make an improvised Tourniquet.
It Takes Too Long
As I already said, bleeding is the most time sensitive problem that needs addressing in a trauma emergency. A person can bleed out from a femoral artery in as little as 2:30. This means, if it takes you 3 minutes to find all of the materials, and make the TQ, and apply it correctly to stop bleeding, your casualty could already be dead.
It's Not Easy
It takes practice making improvised TQs, and knowledge of what is going on in the human body when a TQ is applied. Most people don’t bother with learning that much. If you’re reading this article, then this may not apply to you. (Check out the other articles if you’re interested in learning more)
Improvised TQs Aren’t Trustworthy
You could choose the wrong materials and the TQ breaks making it useless. All that time you spent finding the items, building it is lost when it breaks on you.
Direct Pressure is a Better Option
Your first choice should always be direct pressure. Place a hand directly on top of the wound and apply pressure. This is considered the most effective way to control most types of life-threatening bleeding.
If you hold direct pressure on the wound, you can decrease the amount of blood lost. Soon (hopefully) paramedics will be sweeping onto the scene to take over. But if you let up pressure on the wound so you can track down all the things you need to make a quality tourniquet, your casualty is quickly bleeding out.
And you’re risking the stick you’re using as a windlass breaking, or you can’t get it tight enough.
Better to just hold direct pressure on the wound until help arrives. If you have a helper who can apply direct pressure, then it would be ok to begin making a TQ. But if you’re alone, direct pressure is the most important life-saving thing you could do for the casualty.
The Wrap Up
Now don’t get me wrong. This is still a great skill to learn and a handy bit of knowledge to keep around for when you need it. There are still plenty of circumstances where you might need to improvise a TQ.
My point is that an improvised TQ is not nearly as effective as a commercial made, purpose built TQ, like the CAT or SOF-T Wide. It’s important to know that there’s no substitute for quality gear when your life is on the line.
Carry medical gear when you can. It’s crazy useful and keeps you from needing to improvise at all. However, being able to improvise on the fly is a handy skill to have in your back pocket for that day when the odds are stacked against you.
Come back next week for part 2 where I will go into detail on how to properly construct an improvised tourniquet that will actually work.
Check out our free online course Emergency Trauma Response!