Tourniquet Pass Around

Discussion in 'Bush Medicine' started by Medic17, Dec 11, 2016.

  1. T. Pollock

    T. Pollock Hobbyist Hobbyist Supporter Bushcraft Friend Bushclass I

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    TQ's are on their way to @Subdood and PM with tracking number sent.

    Thank you once again @Medic17 for making this opportunity available to the forum and allowing me to participate!

    Tim
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  2. Subdood

    Subdood Ex-bubblehead Supporter Bushcraft Friend Bushclass I

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    ETA: I did not read Tim or TN Woodsman's review prior to posting my impressions.

    I got the package today. I had previewed the videos and links posted yesterday to familiarize myself in preparation. That said I am still a bit uncertain about the RAT and the TK-4.
    Once I opened the package I took a few minutes and inspected each one for condition. All are in serviceable condition in my estimation as a layperson with no training on Tourniquets.
    For the CAT and SOF-T that includes windlass, capture device, adhesion of any velcro or sliding of buckles, frays or tears in the ribbon attached to the windlass that accomplishes the constriction.

    For the elastic based models this means no frays, tears, elastic visible (except SWAT-T). For the RAT and TK-4 this includes the fasteners to any metal parts.
    ETA: I meant no frays or tears that looked as though they would impede function. As you can clearly in Tim's picture there is a small amount of fraying on the RAT.

    I then attempted a 2 quick tests documented below. I will do some more trials as soon as possible.

    Test 1: attempt to apply to upper left arm as close to armpit as possible with right arm only (I am left handed) and a thin cotton undershirt and a flannel shirt on. I recognize that in a true emergency I would remove the material first, however, I was a bit chilly and A LOT curious, so I deferred the removal of the shirt for later.
    The clear winner hear was the CAT. It was very easy to apply and tighten using just my right arm and bracing / clamping with the left arm extended.
    The next in terms of ease to initially apply was the SOF-T, however, I could not get it tight enough to use properly over the shirt, so it was technically a "fail".
    Third was the RAT, and that was a surprise to me. Simply put, to me It didn't look like it would work. But it did. I am a bit unsure if I used it correctly, and will double check the video to be sure, but it certainly got tight.

    Next was the SWAT-T but it was a real struggle one handed.

    Last was the TK-4. I found it difficult to use and get tight enough and maintain the tension while tucking the end clip in.

    Test 2: Upper thigh (high and tight) over pants with junk in pockets.
    Both windlass models where a relative breeze to put on and use with both hands. I don't have a pulse Ox device, but they were tight!
    1. CAT
    2. SOF-T wide

    Of the non windlass models I already have a preference and that is the RAT. It is so far the easiest of the these style to use by far.

    3. RAT
    4. SWAT-T
    5. TK-4

    I will try to remain unbiased, but to be honest, while they are clearly useful and better than nothing, I don't particularly like the SWAT and TK models.

    Here they are in my current initial order of preference.

    IMG_0613.JPG


    I will update with more over the next few days and will get them out to the next in line on Monday if that suits? Thanks to @Medic 17 for this, as it is a "Most Excellent Adventure"

    ETA: Just goes to show how much personal preference plays in this!

    To be continued.....
  3. Medic17

    Medic17 Supporter Supporter

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    That is two common pitfalls that you mentioned on the SWAT-T and the SOFT.

    SWAT-T
    The trick to one handed application on the SWAT-T is to apply the first wrap loose so that you can easily get a rubber on rubber grip making it easier to apply one handed. Once you get a bite then you can start applying pressure.

    SOFT
    You have to make sure you pull as much slack as possible form the buckle before you start turning the windlass.
    There is not a lot take up on the windlass portion.

    @Subdood
    Awesome Job. Keep training and the views coming.
  4. Subdood

    Subdood Ex-bubblehead Supporter Bushcraft Friend Bushclass I

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    UPDATE
    I have repeated the tests this morning, both shirt on and shirt less. I did not remove my britches and applied all TQs again over Duluth Firehose pants. I did remove my phone and PSK from the pocket prior.

    Test 1: Upper Arm (both L & R, Shirt on and off)
    CAT - Ease of one handed use on either side and ability to tighten make this a clear winner for me.
    SOF-T Wide: After reviewing the video again, I recognized my initial assessment was incorrect. I had the TQ plenty tight for the windlass to operate and apply sufficient compression to stop bleeding. I did have one instance where I had difficulty in securing the windlass. Because the windlass ended up on top of the Bicep the curvature of the arm (and I do not have big bi's anymore :() it required significant effort to get the keeper over the end of the windlass. I am on my PC but once I Switch to my phone I will upload the picture to show what I mean. It required a fair amount of dexterity to manipulate the keeper over the windlass. The CAT doesn't have this problem in my view.

    IMG_0647.JPG

    Additionally these two make it easy to annotate the time applied.

    These two are my clear favorites. I personally give a slight edge to the CAT. I will be getting a blue trainer and a black one for use. ETA: I am deferring final decision pending other reviews and @Medic17 input. However, I certainly feel better able to make an informed decision and not be caught by advertising hype.

    RAT - This is my third place winner. Recognizing the excellent points raised by @T.Pollock and @TNWOODSMAN for me this was the easiest of the three elastic type to apply.

    4. TK-4 but just barely. I still struggled after several iterations on either arm to get the hook properly secured under the wraps. Perhaps with more practice this could be abated, but considering the ease of use for the previous three, I don't see the need.
    5. SWAT-T; Again, I acknowledge the points made in the previous review (dual use). However, I really struggled to get this properly secured.

    I am basing my preferences primarily on the single handed test. For my perceived use, that I cut the crap out of myself (a la Lady in Alone 2 or worse) and must apply it myself that seems the most logical. That said, in two handed use they all proved to be not at all difficult to to apply. I would feel "comfortable" using any of them with two hands.

    There is also another factor, I attempted to account for. If I do have to use one for self aid, I will be in significant pain, and, the site will very quickly become slippery. To my mind, the windlass type would provide the best ability to self apply and stop the flow of arterial blood more quickly. If I mis-apply an elastic one (not stop the flow of arterial blood), I would have to undo it (at least in part) and reapply. For the windlass type, all it requires is to crank down on the windlass more.

    Last observation for now. In the absence of a serious wound, these are painful when properly applied for just this simple exercise. It would seem to me (as someone who has no experience with that type of traumatic wound), that the application of one of these within 3" of a traumatic wound on myself would be excruciating. For me this make the ease of use and ability to quickly and aggressively adjust tension properly all that much more important.

    There may be more, but this is what I have so far. I have PM'd @Scratchthejeepguy for his address and will try to get it out tomorrow. Thanks again to @Medic17 for the opportunity, and @T. Pollock and @TNWOODSMAN for their reviews.
  5. T. Pollock

    T. Pollock Hobbyist Hobbyist Supporter Bushcraft Friend Bushclass I

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    Nice review bro. For those of us who don't/didn't have experience with these there are for sure lots of different aspects of them to consider that at least I hadn't thought of before.
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  6. Bitterroot Native

    Bitterroot Native Scout

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    I would love to get in on this! I was a medic in the Army and have a bit of experience with tourniquets, however I have only ever used the CAT and improvised tourniquets. Would be cool to check out some other models and provide feedback best I can.
  7. Medic17

    Medic17 Supporter Supporter

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  8. NJHeart2Heart

    NJHeart2Heart "NJ Chatty Girl" :) Supporter

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    Thanks @Medic17 . I look forward to the opportunity to learn about these tools.
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  9. Subdood

    Subdood Ex-bubblehead Supporter Bushcraft Friend Bushclass I

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    They are in route to scratchthejeepguy! Thanks again @Medic17
  10. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    I got my package from @Subdood in the mail today!


    [​IMG]

    Step one... Learn how to spell them...
  11. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    About 10 years ago, I was on the "technical rescue team" of our local EMS. I was part of a team that would get called if there was someone who needed a rope rescue, like if they fell of a cliff... Or if there was a missing person in the water and they needed a diver. I found my share of dead bodies (which never needed any first aid) but I did need to learn some first aid in case someone fell off a cliff, so they sent me through some First Responder training where I learned very basic first aid like bandages and CPR, but for some reason... I never learned about tourniquets. (Hey look... I spelled it right!)

    A few years ago, I decided I should probably get a tourniquet so I did a little bit of research, watched a couple YT videos, and ordered up a CAT on Amazon. I played around with it a little and kept it in my range bag for emergencies. I'm very thankful to @Medic17 for letting me participate in this pass around so I can get some more experience with different types, and decide which ones I like best.


    Step two... Learn the correct names for them...
    (And realize that there are only 5, not 6 of them in the box)

    Having basically no real tourniquet experience, I had to do some research to figure out the correct names of each of these so I could remember which ones I liked or disliked. Post it notes to the rescue!
    [​IMG]



    If I'm wrong on any of them, or if I forgot a "T" or something, please let me know. I don't have any more time to play with them tonight and won't have time tomorrow either, but figured I should get the names right before I start playing with them this weekend.
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  12. Medic17

    Medic17 Supporter Supporter

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    Don't sweat the names.
    Learn the equipment, and figure out the minutia later.
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  13. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    Writing up a review and making a short (hopefully short) video....
  14. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    Ok... I had some time to do more research, and have some quality time with these things. First off... I again want to give a huge thanks to @Medic17 for setting this pass around up. I don't know about some of you, but unfortunately, first aid isn't "always" at the top of my priority list when I'm outdoors, and besides band aids... I'm grossly under prepared most of the time.

    Yes I did buy a tourniquet before this, but let's be honest... I had no idea which one to buy and had no idea on how to use it. It's a good thing I never had the need for it, because I probably would have tied it into a shoelace knot, curled up into the fetal position and someone would have probably bled to death.

    But where else can you get 5 different types of tourniquets, have someone ship them to you, give you a week or so to learn how to use them, let you figure out the pros and cons, and which style you like best, and all you have to pay... is shipping!
    So once more... Thanks to BCUSA, all the members who give so freely, and especially Medic17 for this opportunity to possibly save a life.


    I got to put all 5 TQ's to the test. I tried one handed on both arms, one handed on my leg, two handed on my leg, and my daughter had fun donating a leg for me to practice on as well. She learned a lot from this too. I also made note of how much room they take up for packing, and how durable they might be in the field.

    I'm very glad I read the reviews on these as I'm pretty sure I would have had the same experience with the RATS that @T. Pollock did, as it seems like you should slide the elastic all the way in the slot, and I would have probably had to destroy it!

    I'll review them in order of my least favorite to most favorite.

    #5. SWAT-T
    [​IMG]
    While I absolutely LOVE the incredibly simple design of this one, I found it the most difficult to use one handed. It wasn't impossible by any means, but it was hard to get it to start wrapping. Once it did start wrapping, it worked very well, but fastening the last wrap at the end was also the most difficult for me, again... One handed only. Using two hands it worked very well. The multi purpose guy in me sees this as great to have in an emergency also, since it is rather long, very durable, and made of waterproof rubber.
    Weighing in at 4.01 oz it was also the heaviest one I measured.


    #4. SOFTT-Wide
    [​IMG]
    This one was the next heaviest at 3.56 oz and second largest packed size which also brought it near the bottom end of my choices. It was one of the easiest to use though with the durable aluminum windlass, making tightening a breeze, but I did not like adjusting the buckle system with only one hand. I learned to tighten it as best I could with the buckle before using the windlass, but still found it a little clunky to use as it would still slip on my arm sometimes.


    #3. TK4-L
    [​IMG]
    This one was a little easier to fasten the last wrap than the SWAT-T was, since I could use the rubber covered hook end, and slide it in between the layers of elastic fairly easily. It also hooked onto itself very easily, and started the wrap faster than the SWAT-T. This one packed up the smallest, and was the lightest at 1.93 oz, which brought it up to third place. I'm going to assume that someone took off one of the wire hooks and put on the black fish shaped hook. I tried starting it both ways and found using the wire hook was easier to fasten at the end as the last wrap. It still wasn't easily done (by me...) one handed, but the simplicity, small size and low weight made up for it.


    #2. RATS
    [​IMG]
    I really liked this one a lot. It packed up very small, was the second lightest at 2.70 oz, and was by far, the easiest (for me) to use. I found I could get a nice even, wide wrap with it, and the tightness was infinitely adjustable unlike the windlass types. Fastening the end into the cleat was VERY simple and secure, I even appreciated the bright, easy to find orange color! Removal of this one was also the fastest and easiest. There are two reasons why the RATS isn't my favorite though.
    Reason number one is that I thought it could be too short to wrap around an upper leg, especially someone who has bigger legs than I do. I could get it to wrap 4 times, but I still wish there was an extra 6" of length to it. I know this would add to the weight and packed size, but it would make me feel better.
    The second reason I didn't like it was the same reason that @T. Pollock had problems with it. I know "now" to slide the tail just into the cleat, and let it stop... but I can see someone forgetting that easily, and sliding it all the way into the notch getting it stuck. I think the steel cleat should... at the very least, be colored red in the spot that it's not supposed to go, like I did here with a dry erase marker:
    [​IMG]

    Other than those two reasons, I love the RATS and will probably be getting one for a spare.


    #1. CAT
    [​IMG]
    Though it was physically the largest TQ tested, and right the middle as far as weight (at 2.81oz) it has a lot of good things going for it. The Velcro made one handed operation super easy, even from the first wrap. It was easy to tighten the strap without slipping, then fasten the Velcro, then it was just a matter of easily twisting the windlass and locking it into the easy to use windlass clip. The SOFTT-W also had a windlass clip in the form of a triangle, but you had to use another finger to tip the triangle thing up and manipulate the windlass into it. Not very difficult... but the CAT locked super easy and with no confusion. It (along with only the SOFTT-W) also had a location to write the actual time that it was applied, which I like.
    One thing I learned after a few times was the white Velcro strap that covered and locked the windlass, was often in my way when trying to insert the windlass into the lock.
    [​IMG]


    But I soon realized I could move and attach that white Velcro to a better position where it would never get in my way.
    [​IMG]


    Two things I didn't like about the CAT, was that it wasn't infinitely adjustable like the non windlass units, and that it was physically the largest packed size of the bunch.


    Here's a video I made, if you see anything that's medically wrong, please let me know since I'm not a medical professional.



    Thanks again to Medic17 for letting me learn and play with these tourniquets. The knowledge I learn here is incredible, and who knows... one day, it might just save a life!
  15. T. Pollock

    T. Pollock Hobbyist Hobbyist Supporter Bushcraft Friend Bushclass I

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    Great review and video bud.
  16. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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  17. crewhead05

    crewhead05 Supporter Supporter

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    looking forward to it. Thanks
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  18. crewhead05

    crewhead05 Supporter Supporter

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    very good review
  19. Medic17

    Medic17 Supporter Supporter

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    @Scratchthejeepguy
    F^#KIN@ OUTSTANDING REVIEW!
    (Swearing is how inarticulate people express themselves...)

    From a outside perspective your video was short, to the point, and educational.
    If I figure out how to do youtube it would be an example of what I would like to follow.




  20. crewhead05

    crewhead05 Supporter Supporter

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    The only thing I would add, and as always it is situationally dependant. You mentioned 111 minutes for the max time a tourniquet should be used. That is about what I was taught when I initially entered the Army, but as the wars kicked off and progressed we were later taught that if you need to use a touriquet then keep it on until you get the patient to the next higher level of care. Basically yes you may lose a limb but you wont bleed out. Id like to hear what M-17 has to say but I think its one of those things that can be checked after the first two hours. Slowly let off the pressure and see if arterial bleeding continues, if so then strap it back down.
  21. Medic17

    Medic17 Supporter Supporter

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    Please excuse me, I do not have much experience in long term care.

    From what I have been taught 3 hours has been the limb survival rate.
    In the absence of circulation Rhabdo starts to take place and needs to be accounted and treated.

    Some do better, some do not. Medicine is still "practice".
    90% of my patients have been to the ED / ER within a hour from my point of contact.
    At which time they are in the care that is beyond my scope of practice.

    As always it has been life over limb.
    You do what you need to do to get the job done.
    You do what you can to ensure the greatest possible care for the best possible recovery.

    The current field standard is once a tourniquet is applied it stays in place till you see a surgeon.
    (Or someone that can correct the blood vessel problem.)
  22. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    Wow, thanks for the compliments!
    And thanks for giving me the opportunity to make it! I've been needing an idea for my next video. This was perfect, as its not often you get a chance to review multiples types of the same items.

    Plus I learned a lot as well!
  23. Subdood

    Subdood Ex-bubblehead Supporter Bushcraft Friend Bushclass I

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    Not sure I would have been so eloquent, but +1 on this. Great Job. You have set a VERY high bar, no pressure @crewhead05 or @NJHeart2Heart ! ;)
    And I really am Just Kidding. Have fun!
  24. NJHeart2Heart

    NJHeart2Heart "NJ Chatty Girl" :) Supporter

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    Seriously @Subdood I'm in trouble! I will just do my best :oops:.
    It was a challenge just to accept this challenge, to practice with such serious tools. I have a verry strong fear of things that can do damage when not used properly and would normally "run" from danger. That's why this (and knife pass arounds) challenge is so important and such a great opportunity. If I can overcome **extreme** fear of a tool and feel at least reasonably comfortable using it, I can use the thing to save a life. Tourniquets and knives first, then come spring I'll be asking my local bushcraft friends to help me practice with my new hatchet :)
  25. Subdood

    Subdood Ex-bubblehead Supporter Bushcraft Friend Bushclass I

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    No your not, you'll do fine. There is no pressure at all. That's the beauty of this, and @Medic17 knows what he's doing. So relax and have fun. And I am sorry if I created some false sense of competition or pressure. Not the intention. Just relax and have fun!
  26. NJHeart2Heart

    NJHeart2Heart "NJ Chatty Girl" :) Supporter

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    It's all good friend :p:40:
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  27. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    I'm just happy to see so many people that actually want to learn about tourniquets, and I'm even happier that Medic17 offered up an awesome way to let us try out a bunch of them!

    I can't wait to hear other people's input and opinions also!
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  28. TN_Woodman

    TN_Woodman Scout

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    The original TK-4 had two of the same hooks. The TK=4L is the improved version with the fish looking hook from the factory.

    The RATS also had a place to write down the time, but during our time practicing, it tore off. Sorry.
  29. Medic17

    Medic17 Supporter Supporter

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    The new version of the TK-4L still has the big fish looking hook except they added a caribiner style snap gate.

    The fish looking hook is designed to act as a tensioning device.
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  30. Scratchthejeepguy

    Scratchthejeepguy Supporter Supporter Bushclass II

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    When you say tensioning device, do you mean it's supposed to be the starting hook, not the end hook? Or do you mean something else?
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  31. Medic17

    Medic17 Supporter Supporter

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    You start on the fish like you did in your video.
    See time frame 2:30 for reference.

    What is shown is correct.
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  32. TX_redneck

    TX_redneck Supporter Supporter

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    I would love to get in on this as this is something that is very critical.
    And the learning experience from it would be invaluable.
  33. BillyBogota

    BillyBogota Functional Weirdo Supporter Bushcraft Friend

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    I'll have my write up coming soon -- preparation for this school year/the first week of school is always busy for me, but it's almost in the books.

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