Tourniquet VS Israeli Bandage?

[SharpCarbonSteel]

Hello All,

Im trying to finish up my 5 Trauma Kits (2 Bags, 2 Cars, & 1 Home). Money is tight and I cannot afford SOF or CAT tourniquets, only TK4s or maybe SWAT-Ts at best. I know Israelis can be used as tourniquets, as well as primary use as pressure dressings, so should I just get more of those? Aren't pressure dressings potentially less dangerous, if SHTF, and I cant get to medical assistance?

Thank you for any help you can offer.

[proteus]

Get the ones you have training with...if you dont have training with any get some training and then get the ones you had training with. Tourniquets can be potentially life threatening if applied wrong. A medical kit should be stocked with what you know how to properly use first and foremost, IMHO.

[jpg323s]

You don't need to pay $25 for a tourniquet. You can use a cravat, a belt (preferably a pliable/not stiff belt), and nearly any rigid material for your windlass - a screwdriver, fork, a piece of wood (3/4" round would most likely be sufficient), and just secure your windlass with some tape. You can also use a ratchet strap, just make sure you have a barrier between the strap and the skin if you don't want to damage the tissue... with tourniquets, your imagination is the limit, just as long as there's a little common sense.

[Doctorr Fabulous]

You don't need to pay $25 for a tourniquet. You can use a cravat, a belt (preferably a pliable/not stiff belt), and nearly any rigid material for your windlass - a screwdriver, fork, a piece of wood (3/4" round would most likely be sufficient), and just secure your windlass with some tape. You can also use a ratchet strap, just make sure you have a barrier between the strap and the skin if you don't want to damage the tissue... with tourniquets, your imagination is the limit, just as long as there's a little common sense.

The "MacGuyver" tourniquets don't have shit on a real windlass tourniquet. Ask me how I know.

[jpg323s]

The "MacGuyver" tourniquets don't have shit on a real windlass tourniquet. Ask me how I know.

I'm sure experiences differ. Any tourniquet - manufactured professionally, or from random items you barely have time to grab - is only effective if the medic/first responder knows how to apply it, and has the presence of mind, or at least 'muscle memory' to apply the tourniquet correctly.

[Kutter_0311]

SWAT-T's are good IMO. I have 2 in each of my IFAK's and 1 in each GSWK. I also stock plenty of Izzies, rolls of gauze, z-pack gause, some quikclot, and other suff. My best advice is to research the stuff, see how it works, compile a list of stuff you want to stock, then make big orders when your funds line up with sales/good prices. Always stock extras so you can train and replace used stuff, and re-use training supplies to get more training in.

Order a dozen izzies and SWAT's to start with(I always order 12+), just find a good price!

[landser]

tagging this to see what develops

[KnightoftheRoc]

Hello All,

Im trying to finish up my 5 Trauma Kits (2 Bags, 2 Cars, & 1 Home). Money is tight and I cannot afford SOF or CAT tourniquets, only TK4s or maybe SWAT-Ts at best. I know Israelis can be used as tourniquets, as well as primary use as pressure dressings, so should I just get more of those? Aren't pressure dressings potentially less dangerous, if SHTF, and I cant get to medical assistance?

Thank you for any help you can offer.

I'd buy the Izzy's for now, since they CAN be used as TQ's, then get the best TQ's you can find at a later date. This would eventually give you both. The TQ is great, but as mentioned earlier, you need to be trained for the gear you stock, and while the compression bandage can become a TQ, the reverse is not really true. You could maybe get trained on the TQ use while saving for that purchase, and the training may even help you make a more informed purchase when the money is there.

Plus, if I'm bleeding profusely from a head wound, I don't want to see anyone approaching me with a concerned look and a tourniquet. It ain't gonna end well.

[skelco]

Hello All,

Im trying to finish up my 5 Trauma Kits (2 Bags, 2 Cars, & 1 Home). Money is tight and I cannot afford SOF or CAT tourniquets, only TK4s or maybe SWAT-Ts at best. I know Israelis can be used as tourniquets, as well as primary use as pressure dressings, so should I just get more of those? Aren't pressure dressings potentially less dangerous, if SHTF, and I cant get to medical assistance?

Thank you for any help you can offer.

all this tourniquet talk on here makes me nervous as I was always taught that it was a last resort where the limb might be lost anyway. At best it's something that you need to have advanced training to use. I'd be interested to hear the opinions of emergency medical folks and combat veterans on this board who have real world experience with this subject.

[jpg323s]

all this tourniquet talk on here makes me nervous as I was always taught that it was a last resort where the limb might be lost anyway. At best it's something that you need to have advanced training to use. I'd be interested to hear the opinions of emergency medical folks and combat veterans on this board who have real world experience with this subject.

That's a common misconception. Tourniquets can be used in emergencies (when you don't have time to open the 2 packages containing your ETB, then make sure you apply it correctly), then replaced with an ETB/pressure dressing, etc. They should, however, be reserved for life threatening injuries, or injuries that will become life threatening if you don't remove yourself from that situation.

In the last 5 years, the myths surrounding tourniquets have been explained away - at least to me, an Army Medic. I was originally told that after 8 hours of a tourniquet being in place there would be permanent tissue damage; the damage would only increase with time, until the limb was lost. Between then and now, the story has changed numerous times. Now I'm told that a tourniquet can stay in place for up to 24 hours and if the patient is at a proper facility, it can stay on for days - with a medical professional attending to the tourniquet, loosening it, etc.

The bottom line is, it's up to you whether or not you use one. Ask yourself this, "If I'm being attacked by [insert ferocious beast - zombies, honey badgers, etc.] and somehow get wounded (maybe you slice your wrist while climbing through a broken window), will I have the time to properly apply a pressure dressing, or would it be better to slap on a tourniquet and worry about the wound later?"

Just remember, you're going to have blood clots form depending on how long the tourniquet is in place, and the longer it's there the more likely, if loosened by someone other than a professional, those clots will remain whole when traveling to your lungs & heart - not a good end to the day.

[Kutter_0311]

all this tourniquet talk on here makes me nervous as I was always taught that it was a last resort where the limb might be lost anyway. At best it's something that you need to have advanced training to use. I'd be interested to hear the opinions of emergency medical folks and combat veterans on this board who have real world experience with this subject.

Every time a war comes around, civ medicine has to re-adjust to the fact that TQ's save lives. Then, once memory of the war's lessons fades, they shove TQ's down the list to 'last resort.' This is OK in some regards, as the transport time in most cities is measured in minutes rather than hours, but a lot of the US is still closer to BFE than NYC, so I get irritated when my tech school teaches young future cops that TQ's are 'last resort' when most of them will get jobs in little towns where they are the only cop on shift, the only ambulance is volunteer rescue, and the hospital is 90 minutes away when the roads aren't covered in ice and snow.

I tried my best to make it an easy choice: If your first thought is "OMG THAT'S A LOT OF BLOOD!" and the wound is on a limb where you can get a TQ on and stop the bleeding, just go right to the TQ!

[Sixty-Eight Whiskey]

How come that I see some people carrying at least 5 tourniquets on here? I don't know what situation you're planning for...
The way I see it there's practically two situations to use one, either you just lost a limb and there's no good way to apply pressure otherwise until you can get to professional care or you are in the middle of a bus crash with several people suffering from strong bleeding that you need to stop before you can have the time to treat them properly. Both of these scanarios are highly unlikely.

all this tourniquet talk on here makes me nervous as I was always taught that it was a last resort where the limb might be lost anyway. At best it's something that you need to have advanced training to use. I'd be interested to hear the opinions of emergency medical folks and combat veterans on this board who have real world experience with this subject.

That's a common misconception. Tourniquets can be used in emergencies (when you don't have time to open the 2 packages containing your ETB, then make sure you apply it correctly), then replaced with an ETB/pressure dressing, etc. They should, however, be reserved for life threatening injuries, or injuries that will become life threatening if you don't remove yourself from that situation.

In the last 5 years, the myths surrounding tourniquets have been explained away - at least to me, an Army Medic. I was originally told that after 8 hours of a tourniquet being in place there would be permanent tissue damage; the damage would only increase with time, until the limb was lost. Between then and now, the story has changed numerous times. Now I'm told that a tourniquet can stay in place for up to 24 hours and if the patient is at a proper facility, it can stay on for days - with a medical professional attending to the tourniquet, loosening it, etc.

The bottom line is, it's up to you whether or not you use one. Ask yourself this, "If I'm being attacked by [insert ferocious beast - zombies, honey badgers, etc.] and somehow get wounded (maybe you slice your wrist while climbing through a broken window), will I have the time to properly apply a pressure dressing, or would it be better to slap on a tourniquet and worry about the wound later?"

Of course tissue damage time depends on what you do with the arm. Whether it's an unconscious patient or an army soldier actively using that arm to climb. But I give it to you it is probably a lot more used in military applications.
At my civilian emergency service there's the guidline as mentioned at the post's top. Open fracture type 4 and MCIs.

[Doctorr Fabulous]

Here's the dope on TQs, as one of the aforementioned combat vets.
1. PROPER application saves lives, and does not normally result in tissue damage.
2. 8 hours is risking it. Not a problem when even a ground evac to a facility takes less than 4 hours, an an air evac takes less than an hour, but if you're stuck in the woods, you're fucked.
3. If your only experience with TQs and lifesaving was a class in a sterile room, you're not a subject matter expert. If you become a subject matter expert, pat yourself on the back and head off to see the Wizard about the bad dreams. I learned this the hard way.
4. If it's not gonna kill the patient in the next 60 seconds, you probably don't need a tourniquet.
4a. If you're getting shot at, and you might be able to get an evac in the next 5 hours (3 hours buffer for slow pilots), then slap a tourniquet on it and keep shooting.
4b. If you have time to try to figure out whether it's oozing or squirting, he'll be dead by the time you get a tourniquet on there.
5. If you haven't trained at least once per year in first aid, and once every other year in BLS/CLS, forget the tourniquets and go take the class.
6. If you have one tourniquet for each limb, you over estimate your ability to conduct self-aid.
If you carry 3 for you, one backup, and one for a buddy, that's all you.

Just my 2 cents. Wait for some pissed off vet with spare TQs in original packaging to sell some on the trading post. In the mean time, hook up with the Red Cross and learn how to use them, when to use them, and why to use them.

I will also offer this one up to anyone who thinks a belt and a stick is as good as a windlass TQ. I'll shoot you in the limb of your choice. then, I will give you $25 and use a belt and a stick, or you can give me $25 and I'll use a windlass. tehn you get to walk to the hospital. Don't worry, I'll only nick an artery.

Snarky? Yes. Correct? Yes. While I'm all for learning how to improvise everything, medical supplies are one of the places I will never advise one to skimp, especially when you can get 4 CAAT IV TQs for the same price as 4 boxes of decent HP ammo. Then, once you train in BLS, you have two to use, and two to practice with. just mark the practice ones "PRACTICE" in fluorescent paint. Better yet, buy two real ones, then by two airsoft knock-offs and spray paint the knock-offs blue for training.

[ptAltered]

You don't need to pay $25 for a tourniquet. You can use a cravat, a belt (preferably a pliable/not stiff belt), and nearly any rigid material for your windlass - a screwdriver, fork, a piece of wood (3/4" round would most likely be sufficient), and just secure your windlass with some tape. You can also use a ratchet strap, just make sure you have a barrier between the strap and the skin if you don't want to damage the tissue... with tourniquets, your imagination is the limit, just as long as there's a little common sense.

http://www.tacmedsolutions.com/blog/?p=125

The above picture is an example of the difficulties in improvising a tourniquet when a wound is severe enough to require one. As the gentleman pictured noted in an email to us, “… [he] received life-threatening injuries to both upper legs as the result of another shooter’s accidental discharge of his weapon. The .30-06 bullet caused very serious injuries to both legs, but the most critical injury was the severing of my left popliteal artery (the largest artery behind the knee)…” To repeat, this injury is secondary to a weapon not being cleared on a range, not a battlefield wound nor a deliberate attempt on his life by a suspect. As you can see, initial attempts to stop the bleeding with a belt were unsuccessful, as illustrated by the ground saturated with blood. Luckily, the Range Master had a kit that contained a SOFTT, which was applied quickly and saved his life.

Second, the improvised-when-needed reasoning is not sound. This would be analogous to waiting until you had a weapon pointing at your face, then proceeding to quickly constructing a Zip gun.

When a tourniquet is needed I want to have a tourniquet ready! How many people here carry a suitable piece of wood with them, or a long handled screwdriver? Plan A for Massive Hemorrhage shouldn't be "Start looking for components for a TQ!" I prefer the CAT's but the SWAT-T's are cheap and effective.

"Hemostatic dressing with direct pressure, pressure bandage, tourniquet" <--- Effective protocols for massive bleeding. Massive bleeds on extremities should be TQ'ed, then packed with gauze and pressure bandaged.

[jpg323s]

I will also offer this one up to anyone who thinks a belt and a stick is as good as a windlass TQ. I'll shoot you in the limb of your choice. then, I will give you $25 and use a belt and a stick, or you can give me $25 and I'll use a windlass. tehn you get to walk to the hospital. Don't worry, I'll only nick an artery.

I never said an improvised tourniquet was as good one that is manufactured. However improvised is better than none at all. Either way, anyone carrying a tourniquet of any kind, needs to know how to use it. Finally, I could never imagine a situation when I'd have to use an improvised tourniquet on myself, that'd be ridiculous - of course I have more tourniquets than anything other than maybe tylenol & 14ga needles.

[jpg323s]

Also, 2 of the items I listed as improvised tourniquets have been manufactured as tourniquets:

The belt - basically all the TK-4 is, with a hook instead of a buckle - used by the Marine Corp & Ranges before the CAT became widely used:
http://www.gohandh.com/category/tourniquets/

The Ratchet - also used by Rangers:
http://lbtinc.com/ratchet-tourniquet.html

[Doctorr Fabulous]

Also, 2 of the items I listed as improvised tourniquets have been manufactured as tourniquets:

The belt - basically all the TK-4 is, with a hook instead of a buckle - used by the Marine Corp & Ranges before the CAT became widely used:
http://www.gohandh.com/category/tourniquets/

The Ratchet - also used by Rangers:
http://lbtinc.com/ratchet-tourniquet.html

You missed my point. get the training, which includes learning how to improvise a TQ, when to use one, and how to use one quickly. Then pack a real TQ, or two. I find it odd that you would suggest that the OP not need tourniquets, and then say that you don't need improvised tourniquets since you have plenty.

Also, I have to ask, have you ever used an improvised tourniquet on a bleeding patient? SWAT-T and CAAT TQs are tough enough to use when there's arterial spray everywhere. A rigger's belt would be an absolute nightmare.

I'm getting off topic. There's an entire thread about tourniquets and hemostatics on here, IIRC it also has a review of the Rachet. As a side note, the TK-4 sucks like a dyson, and was recalled 3 years ago. We that still have them use them as back-up IV bands or for non-hemostatic uses.

My advice to the OP stands. In specific reply, unless the OP has training on tourniquet use, and specifically training with the TQ he wants to purchase, I say go for the IZZY until you can get the training.

[jpg323s]

You missed my point. get the training, which includes learning how to improvise a TQ, when to use one, and how to use one quickly. Then pack a real TQ, or two. I find it odd that you would suggest that the OP not need tourniquets, and then say that you don't need improvised tourniquets since you have plenty.

Also, I have to ask, have you ever used an improvised tourniquet on a bleeding patient? SWAT-T and CAAT TQs are tough enough to use when there's arterial spray everywhere. A rigger's belt would be an absolute nightmare.

I believe you missed my original point. I wasn't telling him not to get a tourniquet, in fact I was doing the opposite. He said he didn't have the money for tourniquets, so I suggested that he improvise - like I said, improvised is better than none at all.

No I have never needed an improvised on a Human that was bleeding out - like I said I carry plenty and have always had SOF-T's when needed, but I am more than confident that I will be able to use an improvised if it is ever necessary. Again, I don't know if you read or skimmed my post, but I said a pliable belt would preferred for an improvised tourniquet - I agree, a rigger's belt would be more difficult than a leather belt.

I'm sure if you continue to read 3 or 4 words at a time instead of reading my entire post you will continue to find fault with it. I'm not trying to argue if an improvised is better than a manufactured tourniquet, they're not, but they are better than none at all if you need a tourniquet. My original post suggested that he have some sort of tourniquet rather than only Israeli dressings; I then offered some ideas for improvised tourniquets - the ratchet strap is one of the better suggestions (as long as you don't have to put it on your arm) - they're cheap, multiple uses in a kit, and as long as you put some material between the ratchet and the skin, they shouldn't cause any extra damage.

If he needs suggestions on what manufactured tourniquet to buy, here it is - SOF-T. Easy to use, difficult to destroy, roughly the same price as the CAT (plastic/velcro/1 time use before compromised - including practice). I also agree that the TK-4 is crap, but it is a tourniquet.

Overall, just carry a tourniquet of some type - it's better to have one and not need it than to need one and not have it. And, if you have the money, buy a tourniquet, if not, have a plan on what you'd use if you need one.

[polliedes]

I am working on my EMT certification and our training on tourniquets is pretty straight forward.
They do stress it as a last resort, but not so much because of damage so much as because most wounds we will see do not need it.
I think it is probably close to the military method.
Our pnemonic device is DEATH.

Direct pressure with a dressing
Elevate the wound above the heart
Apply pressure to the supplying artery
Tourniquet
Hospital

We are taight to use cravats for tourniquets primarily.
Like most people have said, training is the most important thing for applying a tourniquet.

[Doctorr Fabulous]

jpg, feel free to take this to PM. I read your entire posts, and I'd be happy to explain everything I said in direct context.

I'm calling shenanigans on the thread until the OP can give more guidance, as far as what training he has, etc.

[jpg323s]

There's no need to PM. My original suggestion for the 'Tourniquet VS Israeli Bandage?' topic stands. Have a tourniquet, if you can't afford one, make one and know how to use it, like everything else in your kit.

[USMCGrunt/USAFCATM]

For the youngsters here, once upon a time, we were issued ALICE first aide kits that came in a little green plastic box carried in a nylon pouch with ALICE clips that we wore on our ass-packs. Wanna guess how many CAT, SOF-T or other pre-made tourniquets were in those kits? That's right, none! We were trained to rip off our web belts (the ones on your trousers, NOT your ALICE belt) use any strong, straight object like a stick, the old angle-head flashlights (what the hell is Surefire back in the 80's) or even a bayonet with the belt being turned by the handle (don't cut yourself on the blade when doing this) to tighten our improvised tourniquets. That's right kids, we didn't get all this fancy pre-made stuff, we made our own!!! Now GET OFF MY LAWN!!!
I will admit that these days, the CAT touniquets we have these days are pretty sweet and a lot easier to use and I have several around here. However, I am just saying that just because you don't have the latest and greatest, you can still find ways around it by using your head and the materials you have available to you. Sure, it's not as easy to use as the new stuff but we were keeping blood in people long before the pre-made stuff came out and we're still here to talk about it.

[KnightoftheRoc]

For the youngsters here, once upon a time, we were issued ALICE first aide kits that came in a little green plastic box carried in a nylon pouch with ALICE clips that we wore on our ass-packs. Wanna guess how many CAT, SOF-T or other pre-made tourniquets were in those kits? That's right, none! We were trained to rip off our web belts (the ones on your trousers, NOT your ALICE belt) use any strong, straight object like a stick, the old angle-head flashlights (what the hell is Surefire back in the 80's) or even a bayonet with the belt being turned by the handle (don't cut yourself on the blade when doing this) to tighten our improvised tourniquets. That's right kids, we didn't get all this fancy pre-made stuff, we made our own!!! Now GET OFF MY LAWN!!!
I will admit that these days, the CAT touniquets we have these days are pretty sweet and a lot easier to use and I have several around here. However, I am just saying that just because you don't have the latest and greatest, you can still find ways around it by using your head and the materials you have available to you. Sure, it's not as easy to use as the new stuff but we were keeping blood in people long before the pre-made stuff came out and we're still here to talk about it.

Yep! Of course, some of those people are typing with one finger now, out of necessity...
Personal pet peeve, but it's a Webb Belt. Webb being someone's name, not a descriptor. Even my drill sergeants didn't know this, and it's become so commonly used anymore I half doubt the Pentagon uses the poor guy's name correctly anymore. A "web belt" would have more holes in it than the pistol belt does.

[IANMCDEVITT]

German dude is right. DOC torr has a few points also...........I will give you all some advice. Everyone reading this lurking and contributers, training is optimum, an improvised tourniquet is better than none, and don 't ever, EVER rely on an "Israeli dressing " or emergency trauma dressing as a first line tourniquet unless you absolutely have nothing else. It is not billed by the makers as a FIRST LINE TQ FOR A REASON.....
And as an ASIDE? I am more than willing and able to throw around the "who 's got the most experience" bullshit. AND IT CAN BE DONE OFFLINE. For any of you clowns not observant, I USE MY REAL NAME AS MY SCREEN NAME. I WROTE THE FIRST BOOK PUBLISHED ON TACTICAL MEDICINE 13 years ago BEFORE the war, before it was "cool " to bill yourself as a Tactical Medic. 4 years ago Harvard University School of disaster medicine adopted MY INFO for their texts, SO STICK TO THE FREAKIN TOPIC AND STOP CHALLENGING EACH OTHER. ...........There...........rant off.


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