Stop the bleed | TheaterFire

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pretendlawyer13@reddit

A little late to this but do they give you any sort of certificate?

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JoshuaGraham45@reddit (OP)

I’m not sure. But here is their link https://www.stopthebleed.org/

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p0l4r1@reddit

Tourniquet needs to be at the highest point in the thigh you can get it

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TCCC guidelines are reviewed and revised on a yearly basis. I think the current guideline is to place tourniquets proximal to the source of bleeding unless the site isn’t readily apparent, in which case high and tight is the recommendation. In any case, high and tight isn’t explicitly wrong.

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Main-Quote3140@reddit

Current is high and tight. There's nothing wrong with proximal but there's also nothing wrong with high and tight. Under pressure high and tight is harder to fuck up which is why that's what's taught.

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oh_three_dum_dum@reddit

That was almost directly from the 2021 TCCC guidelines publication. It was the most recent one I could find.

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p0l4r1@reddit

I participated in FDF urban combat exercise few weeks ago, high and tight is currently the way to go according to FDF protocols

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Cheezemerk@reddit

If you are prepared to make holes, be prepared to patch them.

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EpicGuard@reddit

I did first aid several times in Boy Scouts and as a security guard. The number one thing people were always surprised to learn was that you really, *really* have to stuff some bandage down into big holes or cuts. Stuff it like a turkey.

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Ye-Hu@reddit

>Stuff it like a turkey. https://i.redd.it/uy9obdidisxa1.gif

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Cheezemerk@reddit

I had quite a bit of training to get my eagle, and that's probably where i get my philosophy. But so few who carry take any medical training, it is becoming more common but not nearly enough. The other thing that bothers me is so few people who carry a gun carry a trauma kit. I carry a basic kit (TQ, 2 quikclot gauze, an Israeli bandage, 2 chest seals) if i am carrying a weapon. If im prepared to fight, i need to be prepared to patch some leaks on myself or anyone else.

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Drake_Acheron@reddit

Unfortunately, it really isn’t the best idea. Morally sure, but legally, well, not so much. https://m.youtube.com/watch?v=g1UQJLukqoM

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smokeyser@reddit

That's a little ridiculous. Using that logic, nobody should ever leave the house because a corrupt prosecutor could lie and convict them of crimes they didn't commit.

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Drake_Acheron@reddit

It’s not my logic, it’s two lawyers, using their extensive experience in 2A specific cases. I’m not using an argument of authority, but rather, these lawyers ONLY deal in 2A and self defense cases. So their pool of anecdotes is arguably big enough to project a pattern. Would I still carry a kit myself? Yes! I’ve been trained in COR since I was 7, forest rescue since was 16, the stuff you learn in basic, and the various trauma courses my mother enrolled me in. (She has a PhD in nursing and wanted me knowledgeable) I wasn’t necessarily making the argument against the idea entirely, merely saying it’s not as simple and obvious as the other commenter stated.

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smokeyser@reddit

> I wasn’t necessarily making the argument against the idea entirely, merely saying it’s not as simple and obvious as the other commenter stated. It really is, though. The fact that someone on youtube said it's not a good idea shouldn't be a deterrent for anyone. People say stupid things online all the time. If you think that's crazy, get this... There are doctors on youtube giving bad medical advice! And accountants giving bad investment advice. It sounds crazy, but it actually happens!

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Drake_Acheron@reddit

I think in order for it to be bad advice, the content has to be a lie or not based on evidence. Theirs is based on true accounts they have experienced. Also, their advice is absolutely NOT hardline in the video it’s mostly just food for thought. Furthermore, Armed Attorneys have a fantastic reputation, and I think you are being a tad disingenuous with your characterization.

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FatherJB@reddit

honestly its never something I've thought about but it makes complete sense. Thanks for the info.

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ColtBTD@reddit

This. I always keep a full medkit in my vehicle as well as a couple TQ’s, hell even if a motorcyclist crashes in front of you, it’s stupid not to have quick clot and TQ’s and other general medicine. All of my bags have basically the same IFAK. Range back, camping bag, vehicle bag. Keep the same stuff so you always know what you have

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Cerberus73@reddit

This is why people with actual trauma experience and training laugh when people say you should have tampons in your range bag. I mean, you CAN, but not for patching bullet holes.

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smokeyser@reddit

So you're saying I should carry pads instead of tampons for patching bullet holes?

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CWM_99@reddit

Tampons are awesome for a bloody/broken nose

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Atlhou@reddit

> I mean, you CAN, but not for patching bullet holes.  Actually heard that as a remedy from the trainer in basic first aid, and CPR Training.

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Dustoff_Medic@reddit

I used to give them to the Iraqi army for nosebleeds, I wasn't a dick about it, eventually I would cut the strings after my joes stopped laughing

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Cerberus73@reddit

I've heard it, too, sadly. Neither of those are trauma-level courses and your instructor was speaking above his level.

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Dustoff_Medic@reddit

Preach!

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GukyHuna@reddit

Yeah I’ve seen videos of wound dressing training and you need literal feet of gauze you have to stuff in the wound ain’t no way a tampon is stopping that.

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Rusty_Shackalford@reddit

Not even heavy flow ones? /s

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heili@reddit

Even the ultra-absorbent ones will only hold about a half ounce of fluid before it just starts flowing right through.

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Rusty_Shackalford@reddit

I guess people can't take a joke.

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heili@reddit

You can, in case someone's period shows up unexpectedly early while on a range trip. But do not use them for wound care. It's not what they're for, and they're not good at it.

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Oak_Ranger@reddit

If you are unsure of where to put the tq. High and tight, put it as high as you can and as tight as physically possible.

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greyhunter37@reddit

If 1 and 2 are effective don't do 3 !

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Pizzaman_42069@reddit

Stop the Bleed instructed here. For everyone in the comments arguing about this stuff in the comments… it depends on context. For really bad bleeds (massive hemorrhage) I just tell people to “Tourniquet the limbs, pack the junctions, seal the box”. The big thing here is getting blood loss under control as quickly as possible. For really really bad bleeds, for limbs just throw on a tourniquet, the risk of using these isn’t as high as it used to be. High and tight is great on combat situations when you don’t have time to assess the wound and just need to stop bleeding. If you have time to assess the would, 3ish inches above is good, just don’t place the tourniquet over any joints. The junctions refer to areas like the armpits and groin… lots of arteries, impossible to tourniquet. That’s really where quality wound packing is needed. Plenty of good info on the internet on this subject. For the “box” that’s referring to the thoracic region (rib cage area). The big risk here is developing a tension pneumothorax which is why any holes here need to be sealed off. A chest seal is preferable, but covering it with your (hopefully gloved) hand can work. I’ve seen people improvise chest seals with chip bags and tape. Abdominal wounds are tricky and really should just be dressed. Don’t pack them - too many internal organs you shouldn’t be poking. For less serious bleeding control, the order given in the post is perfect - most bleeding can be stopped by pressure. What i listed above is really for major trauma. And of course, get training. The hands on part of the course is by far the most important. Oh and don’t place a tourniquet the neck guys…

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Fnata_@reddit

Excellent comment, exactly how I was trained, listen to him guys.

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Pizzaman_42069@reddit

I will say I wouldn’t recommend teaching pressure points to the average layperson. It used to be taught but it’s no longer being taught due to mixed (usually poor) results. I’ve seen some super experienced guys use it to good effect, but those guys have been dealing with this kind of stuff for years. Most people (especially on this sub) don’t deal with people bleeding out daily and in a situation like that have their adrenaline shooting through the roof (think shakey hands/loss of coordination). Mix with slippery bloody skin and a thrashing screaming patient… good luck finding the pressure point. Just keep it simple. Use a knee to apply direct pressure (looooots of pressure) to the wound while you apply a tourniquet.

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Fnata_@reddit

Good point, guess it depends on the instructor, I was taught how to use the pressure points in a class a year ago.

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IncontinentiaButtox7@reddit

I tend to disagree with the order of these steps. Put the tourniquet on first unless the wound is in an area that can’t be tourniqueted.

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popNfresh91@reddit

Depends on the type of bleed.

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dudas91@reddit

No. That is objectively wrong and in doing so you are likely to do more harm than good. Stop the Bleed program is overseen by the American College of Surgeons (THE overarching medical association encompassing basically all surgeons in the US) and a lot of the research associated with the Stop the Bleed program comes from years of treating trauma cases as well as from

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oh_three_dum_dum@reddit

Situation dependent. In most environments (outside of combat zones or out in the back country) a hospital is close enough that a tourniquet won’t be on someone nearly long enough to cause permanent damage.

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Main-Quote3140@reddit

Even in combat there's almost no situation where a tq will be on long enough to cause permanent damage.

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oh_three_dum_dum@reddit

It’s more likely than in normal civilization.

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Due-Net4616@reddit

You don’t know much about medical training then. Medical professionals don’t train everyday people to a professional standard, it’s dumbed down for lay people. This is a logical path for lay people but professionals would be able to identify the difference between a simple laceration and an arterial bleed. It’s just like CPR/AED is taught to the general public but professionals learn BLS instead.

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wasframed@reddit

If it is a reputable TQ, there is no risk of nerve damage from its use. the GWOT has shown that TQs can be on for 8-12 hours before any risk of appendage damage stemming from the TQ use itself. The TQ as a last resort is completely outdated.

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MC_McStutter@reddit

That’s not true. There’s no risk of putting a tourniquet on *if done properly* The thought process of tourniquets being used as last resorts is outdated and studies from combat zones have proven that the risk is extremely low

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draxtheslayer@reddit

Unfortunately that’s inappropriate for most situations, most externals lacerations and punctures can have the bleeding stopped with simple external pressure.

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IncontinentiaButtox7@reddit

I think it is just easier to train people to slap on a tourniquet if they see a lot of blood. There is very little down side to tourniqueting. Even in a situation where a lesser intervention would have worked the tourniquet will work just as well. Nerve damage caused by tourniquets is mostly a myth especially if the tourniquet is only on for a few hours.

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draxtheslayer@reddit

See I do agree with you about the nerve damage and the negatives of a tourniquet are all kinda bs, but i like to use to KISS abbreviation here, just apply heavy pressure and wait for proper medical intervention rather than everyone in the general vicinity knowing how to use a CAT tourniquet

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Main-Quote3140@reddit

This is backwards thinking. Tq then let the medical professionals decide wither to take it off and pack or not. There's a reason the military teaches when in doubt tq.

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Main-Quote3140@reddit

Putting a tq on when it's not necessary isn't going to hurt anyone (it's going to hurt a fuck ton but you know what I mean), not putting a tq on because you try packing first when it does require a tq is how people die.

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popNfresh91@reddit

As an army medic I just want to point out that you should avoid applying a tourniquet over a joint or hard bone like your shin or forearm ( unless you’re absolutely yoked and that’s the only place you can get it on). Tourniquets work best when they compress as much soft tissue as possible. Also, they can be left on for a couple hours before permanently damaging the rest of the limb. Doctors Leave them on for several hours while performing certain surgeries. But if it has been on for a long time, please make sure a medical professional is there when it comes time to take it off.

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aeonicentity@reddit

I'm glad the acronym is WWSD. Eugene would be proud.

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FrenchFriedMushroom@reddit

I was told (I don't remember where) to only use a tourniquet if the wound is potentially fatal without it because typically everything below the tourniquet will likely have to be amputated. Is that true?

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RagnarLongdick@reddit

If someone is bleeding profusely and you have a tourniquet that goes on first

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jamany@reddit

100%. Not great that people are making misleading medical infographics

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akkopec@reddit

I think the idea is your try to stop the bleed with pressure before applying a tourniquet . Totally dependent on the wound. Don’t just slap a tourniquet on someone just because they are bleeding

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jamany@reddit

Catastrophic bleed = tourniquet on first.

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Haha1867hoser420@reddit

Yeah, of course if you struck the femoral, there is no point in packing the wound with gauze before putting on a tourniquet. But if it is a smaller wound, sometimes a tourniquet won’t be necessary after you bandage it.

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GrimClippers11@reddit

This is the correct. Got CLS certified this in the last year along with 2 refreshers, and every one of them says tourniquet, then pack the wound. Otherwise the packing can disguise improper tourniquet use, leading to continued blood loss. Always remember high, tight, and over the clothes.

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the901@reddit

Yeah. Though I was going crazy there for a sec.

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Snake3452@reddit

Also find this odd. For this exact situation I was taught TQ then pack the wound.

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PseudonymousPlatypus@reddit

TQ first. Then pack the wound. Weird for ACS to put out this slightly backwards order of treatment. If you have a TQ on your person, and the wound needs a TQ, that should absolutely go on immediately and before you whip out any gauze or bandages.

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doc6404@reddit

For the love of God; a tourniquet is an absolute last resort. I would rather see people carry a dozen Israeli bandages or simply gauze than rely on solely a tourniquet. I teach a tourniquet is only justified in a traumatic amputation. Otherwise, pressure will do the job. A tourniquet left on for even a few minutes can equal a loss of limb. Always think before applying a tourniquet: "If I put this on, I'm saying this person would be better off at this moment without this limb. There is no saving this limb, and I believe I can save this person's life from blood loss by sacrificing this limb." Otherwise, do something else.

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Main-Quote3140@reddit

You need a new job.

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Wooper160@reddit

Me when I spread misinformation on the internet

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diensthunds@reddit

Odd. As an Army Medic we went with them for any significant bleed. Of course we were also taught that you can leave them on for up to several hours without the limb becoming necrotic and being lost and you could slightly loosen them, monitor to see if the bleeding has subsided to the point of using an Israeli baggage while leaving the CAT in place in case you needed to tighten it. Hmmm maybe we just didn’t know what we were doing and weren’t actually training to save lives after all though.

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dafreshfish@reddit

I took a STB class a year ago and our instructors told us to be VERY careful of counterfeit TQs. Legit CAT TQ's cost around $25-$30 and should have two sets of markings identifying the manufacturer date and generation of the TQ. I saw a vendor selling first aid kits with fake TQs at a bike festival. Super sketchy. Last thing you want to do is attempt to secure the TQ and then have it snap apart. The other thing they taught us to familiarize yourself with different TQs esp. if you have small children and pets. CAT TQ's work for adults of medium to larger builds, but the SWAT-T TQ works better for kids and pets as well as adults with thinner arms.

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MC_McStutter@reddit

Quick tip for tourniquets: pull the tourniquet as tight as you can BEFORE you tighten the windlass. You should only have to do 2ish rotations to stop the bleeding this way. The Army found that most injuries being caused by tourniquets were caused by them being kept on too long, but by the tourniquet being applied improperly. The band inside the tourniquet is about 2/3 the width of the overall tourniquet, so the reduced surface area has been known to cause permanent nerve damage if the tourniquet itself is too loose and the windlass tightened too many timesb

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McGobs@reddit

My TECC class just told us to buy SAM-XT tourniquets. They have an auto latch function when it's tight enough, then 2-3 turns. Everyone recommends CAT tqs, not sure if they have the same feature--just watched a video and didn't see the auto latch.

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MC_McStutter@reddit

I’ve never heard of those until now, but they’re approved by CoTCCC. If that’s what you’re most comfortable using/carrying, then go for it!

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McGobs@reddit

My instructor was E Reed Smith, who is on the [board of CoTCCC](https://www.c-tecc.org/about/structure/board-of-directors). Fantastic class and great guy. He said one of the reasons he liked them was because they were the most rugged and durable and idiot proof. The SAM-XTs would just last class after class and he needed to replace them the least, as well they are just intuitive.

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the901@reddit

We were taught this but not why. Thanks for the background info.

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MC_McStutter@reddit

I don’t understand why people don’t teach “the why”. Knowing “the why” can be crucial to help people remember to do it

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MrTastey@reddit

Note that the tourniquet is placed 6+ inches above the wound but not on a joint, this is very important. I have also heard some military guys say they are trained to go as high up on the appendage as possible “high or die”

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FellsApprentice@reddit

That should be step 1, 3, 2 actually. Source, former medic.

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diensthunds@reddit

Is it just the poster or does that placement look like it could have gone below the joint and still been 2 inches above the wound?

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FellsApprentice@reddit

No, I would have place it above the knee as well 2 in above that wound would have been almost right on top of that joint and I would want a little more space around the joint then it would have given. That or just gone straight up high and tight.

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diensthunds@reddit

Yea but if they end up amputating then they have to take the joint as well since it was below the placement of the tourniquet. With going below possibly could have saved the joint for use with a prosthetic later on. Hard to really tell in the picture though.

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FellsApprentice@reddit

That's not really true, that tourniquet has to be on for 6 hours at least for there to start to be permanent damage.

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diensthunds@reddit

Right but in a lot of our areas we were at it was a “And you may have to sit the patient for 24 hours before we can get them out” So we had to try and save as much as we could not knowing how long we might be before a bird could pick up the pt.

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Magnum_Snub@reddit

Put a thumb in it

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Top-Feed6544@reddit

fuuck i cant imagine have to press dressing into yourself if you had to.

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GearJunkie82@reddit

Took a STB class recently. Much of it was review from previous training, but I did learn a few things and it's always good to give your skills a refresh.

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fightfortheright603@reddit

Just signed up for a free class at the sig sauer academy

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dudas91@reddit

For anyone that doesn't know... Stop the Bleed runs completely free hands on classes / trainings that are open to anyone. They are usually tought by trauma nurses that actually use the skills in real life. They also have a free online course that anyone can watch. https://www.stopthebleed.org/training/

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Usingmyrights@reddit

They aren't all free. I've seen some that were 100 or more.

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dudas91@reddit

Weird. I've never seen one that's paid and only ever encountered free ones in my area.

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TrumpIsMyGodAndDad@reddit

Heyo Im an instructor for STB and yes it’s fantastic and everyone should take it! Could really help you save a life.

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LetItHappenAlready@reddit

Only classes within 50 miles of me are $50 lol.

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DaAingame@reddit

Hijacking top comment to also say try reaching out to your local teacher. I did the training through St. Francis in Tulsa, and if you can get a group of 10 together they'll even travel to you to teach it. I'm sure it's different place to place, but never hurts to ask! We also got to keep all our supplies, like the TQ and bandages.

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theEdward234@reddit

Didn't know about the online course, will check it out for sure since my schedule is pretty packed and don't think I'll be able to attend in person course.

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SammyTheBEAST@reddit

Thanks for sharing! Just signed up for one close to me

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0LDHATNEWBAT@reddit

Tourniquet goes on first. The pants should be cut off and the TQ applied to an area with bare skin. The TQ should be applied as close to the torso as possible even if the wound is toward the extremity.

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Peacemkr45@reddit

too many people will see these "motivational posters" and think they know what they're doing. It's Bullshit. You need to be actually trained to know when and how to apply treatments and where not to. When you find yourself in a situation that presents as excessive bleeding and the person losing blood screaming, you will forget what you saw on a poster.

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Mental_Article_4785@reddit

Learned this in High School

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Fby54@reddit

And remember that if the tourniquet is working then it’s gonna be one of the most painful things you ever experience to wrench it on

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GukyHuna@reddit

Had a coworker who shot himself in the thigh on a mountain in the middle of nowhere with a .44 and he said the pain of the tourniquet was so bad he literally just blacked out and can barely remember it being put on him. He then got stabbed in the face at work multiple times not too long after and is still kicking the luckiest and unluckiest guy I know.

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Atlhou@reddit

No tourniquet for the face stab?

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79TranZam@reddit

Instant nosebleed relief.

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Explursions@reddit

Instant everything relief.

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TheBlackKing1@reddit

Tourniquets are only for arms and legs pal

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OMalley30-27@reddit

Pretty sure buddy was joking

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TheBlackKing1@reddit

Whoops

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Slight_Snow8564@reddit

It doesn't hurt that much. Source: used to do daily tourniquet drills.

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Vew@reddit

And the longer you leave it on. In our class we only left it on for short period of time, but damn it makes the whole area cut off hurt (not just where the TQ is placed) and it progressively gets worse.

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sequesteredhoneyfall@reddit

It's not *directly* related to your comments here but I figured I'd mention this since it's tangentially related: Leaving tourniquets on for long periods of time is best practice if a TQ is indeed needed for the given wound. The idea that you should only leave it on for X amount of time (usually like 30 minutes or an hour or so) is a total myth at this point. It's still good to note the time, but for different reasons.

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Wildcard556@reddit

I actually took this class recently. The instructor, when we started working on the dummies, said: “find the hole that makes you happy”. I laughed and he said: “you’re a dirty, dirty boy” 🤣🤣🤣

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kissmyfartichoke@reddit

Always take note of the time when you apply a tourniquet

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Fit-Paper-797@reddit

How much tome should You put on a tourniquet?

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Dogsquatch@reddit

In general, 2 hours. You should be able to obtain professional medical help within that time period. A leg can handle ischemia for longer than that, but at approx 4-6 hours permanent damage can occur. Bleeding to death will kill you faster than limb ischemia, however.

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SneakyWasHere@reddit

A chainsaw kissed my thigh last summer and I used my belt as a tourniquet for my trip to the hospital. I was proud of how well I stopped the bleeding, but the doctors and nurses were all concerned and made me take the belt off and just apply pressure. Apparently a tourniquet should be used as a last resort and only if you hit an artery, otherwise you’re just cutting off circulation to the limb and can risk losing it.

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MC_McStutter@reddit

That’s a myth. The army has proven that through numerous studies of battlefield injuries. Unfortunately, it takes a few years for civilian healthcare to catch up to current trauma doctrine.

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oh_three_dum_dum@reddit

I mean it isn’t exactly a myth, it just takes a really long time for a TQ to start causing serious problems like that. In a normal setting where hospitals are accessible within a reasonable amount of time it isn’t a big concern though.

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atsinged@reddit

Take a Stop the Bleed class. The whole thing about tightening and loosening a tourniquet is old news, a lot was learned from military casualties in the last decades, strap it on and leave it on until a trauma doctor takes it off. They don't even teach us to note the time anymore.

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englisi_baladid@reddit

A properly applied tourniquet has incredible little risk of limb loss if you get to the hospital in any reasonable time.

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heili@reddit

And for fuck's sake if you are one of the people who carry tampons because "They're for plugging bullet holes!" fucking stop it and learn some actual first aid.

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New_Mathematician352@reddit

I had an argument not too recently with someone who proclaimed that a TQ should only be used “on an over enthusiastic first aiders neck” and “a tampon is more that sufficient for most wounds” He just would not accept that times had moved on from TQ’s made of tube & a stick of some sort and applying countless field dressings to catastrophic bleeds until either the casualty was dead through blood loss or by some miracle the dressings were piled on so high that it actually stopped the bleeding Needless to say he was quickly and repeatedly called a dickhead and eventually deletes the thread.

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TheResurrectedOne@reddit

Very stupid question since I'm a dumbass about first aid - does the tourniquet go above or under the place where it's bleeding?

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oh_three_dum_dum@reddit

Always above. Or, if that doesn’t make sense, closer to the torso than the wound.

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zmaint@reddit

Between the heart and the wound. Need to stop the pump from being able to pump blood out the hole.

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TheResurrectedOne@reddit

thanks

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ioapwy@reddit

Above - heart side

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Ambitious_Promise_29@reddit

I was told by a combat medic that in in all likelihood if a tourniquet is needed, the little tab where you are suppose to write the time stands a pretty good chance of being covered with blood, and it works better to write the time on the injured person's forehead.

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oh_three_dum_dum@reddit

This is true. You can even use their blood to write the time on them if you don’t have a pen.

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Minibinaz@reddit

Useful poster, but I feel like it should make it more clear on TQ vs dressing usage. Like putting the two side to side, like an either/or analogy. A person reading this at a range might assume they’re supposed to always apply dressings and then TQ it. If it’s spurting and they’re using a dressing, they’re wasting your time. If it’s oozing and they’re throwing a TQ, they’re wasting your limb.

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Minibinaz@reddit

I like the reply by u/dudas91 , just taking the class is 10/10. I did basic Marine TCCC but I’ve been a lazy bum about taking more essential courses on first aid.

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oh_three_dum_dum@reddit

If you can afford it, the NOLS wilderness medicine courses are very good. They have different levels - wilderness first responder, emt, etc. They provide relevant medical knowledge at whatever level of certification you’re seeking but tailor the treatment methods towards environments with limited resources and extended evacuation times so there’s a bit more focus on improvisational interventions (making splints, TQ’s, litters, etc.) out of what’s available and extended patient care.

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oh_three_dum_dum@reddit

That’s why literature is best combined to with in-person instruction and practical application for things like this.

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LowPolyHorse@reddit

Nuh Uh https://i.redd.it/4rfj7rqtqixa1.gif

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Beauregard_Jones@reddit

Maybe goes without saying, but call 911 first. Also, pack several pairs of gloves in your EDC. You'll want the gloves to help anyone in need. And if you're in need of help, having gloves to give someone may make them more willing to lend a hand.

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11chuckles@reddit

Yeah, blood loss will definitely wait for you to talk to 911, and the ambulance is only minutes away when your patient potentially has seconds before you waiting to apply the TQ makes things worse

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oh_three_dum_dum@reddit

You should assess the injury and prevent life threatening bleeding first and foremost. If possible have someone else call 911 at the same time, but if someone needs a tourniquet and you wait to help them until you call 911 they might be dead by the time you get around to helping.

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ArmyVetRN@reddit

Here’s a great resource to delve a bit deeper for [those interested in learning](https://youtu.be/PF5GhoYKK3g)

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Justhereforther34@reddit

Remember to place the tourniquet 2-3 inches above the wound directly on skin

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RagnarLongdick@reddit

Naw don’t do 2-3 inches, high and tight.

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MC_McStutter@reddit

Hasty tourniquets are high and tight. You don’t do high and tight outside of a combat scenario, even in the military

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wasframed@reddit

You do it high because bullets fragment when they hit bone or other objects. Those fragments can travel up the appendage making other bleeds that you can't see. Put the TQ as high up the appendage as possible.

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MC_McStutter@reddit

That’s not true. If you’re using that logic to stop the travel of fragments and shrapnel, it’ll be able to travel the entirety of the limb, which is not a thing. Additionally, it’ll only travel like that if it travels in the bloodstream. Lastly, that’s not a concern that someone in the street should have, as you are not going to be operating on them. A tourniquet will not prevent additional internal injuries

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wasframed@reddit

>That’s not true. If you’re using that logic to stop the travel of fragments and shrapnel, it’ll be able to travel the entirety of the limb, which is not a thing. Additionally, it’ll only travel like that if it travels in the bloodstream. Lastly, that’s not a concern that someone in the street should have, as you are not going to be operating on them. A tourniquet will not prevent additional internal injuries Wut? You're not using the TQ to stop the travel of fragments in the bloodstream??? You're using it to stop bleeding caused by fragment paths farther up/down the limb. Bullets and their pieces will take the path of least resistance. If a bullet strikes a bone and breaks apart, who knows which way the pieces go. They might create additional bleeding which must also be stopped. Story time: During my OEF 12-13 deployment the 2nd PSG got hit in the shoulder, entrance was anterior above the clavicula. Exit wound was through the glute (his ass cheek). The bullet went through the deltoid, crushed his scapula redirected down the back of his ribs, hit his pelvis and went out through the meat of his ass. Couldn't TQ it, but shows how unpredictable GSWs can be. So like I said, if you're dealing with GSWs (or shrapnel for that matter) put the TQ as high up the appendage as possible.

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MC_McStutter@reddit

You’re going to want to stop the bleeding from the main source of leakage. That’s the entrance and/or exit wound. Even the army teaches 2-3” above the wound outside of “care under fire”. Saying you should always do it high and tight is silly, especially since there are more applications for a tourniquet than GSWs. Also, using an example that doesn’t pertain to the argument you’re trying to convey is a little silly.

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wasframed@reddit

You will stop the bleeding everywhere below the TQ. So if you put it as high up the appendage as possible. You'll stop not only the main source but also any unseen sources too. The example was to show the unpredictability of GSW wounds. Not sure why this is such a hard concept for you. And I'm really fucking glad you weren't one of my medics during my deployments.

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Justhereforther34@reddit

You need to download Deployed Medicine or Up To Date bro. Your entire argument is based off of what you learned in a CLS class 10 years ago that you weren’t paying attention in. Half the shit you’re making up lol

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wasframed@reddit

Or that's what my PLT and Co medics recommended and what I literally watched them do in country as I was calling in a 9-line. If TRADOC has sense evolved. O'well. Call me wrong then. But I literally watched high up the appendage work IRL.

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Atlhou@reddit

> from the Care Under Fire Section...  Which is exactly the point u/MC_McStutter was making. This is the real world where unless you stumble upon a firefight, the rules are a little more relaxed.

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wasframed@reddit

>This is the real world where unless you stumble upon a firefight, the rules are a little more relaxed. No, this is r/Firearms where 99% of people have no medical training. Hence, they should just throw on the hasty TQ high and tight and let EMTs/hospitals add additional deliberate TQs above the entrance/exit wounds after they have actually assessed the injured. "high or die" became a saying for very real reasons.

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wasframed@reddit

EDIT: So I did google Deployed Medicine, straight from the Care Under Fire Section... >Apply the limb tourniquet over the uniform clearly proximal to the bleeding site(s). **If the site of the life-threatening bleeding is not readily apparent, place the tourniquet “high and tight” (as proximal as possible) on the injured limb and move the casualty to cover.** [Source](https://books.allogy.com/web/tenant/8/books/b729b76a-1a34-4bf7-b76b-66bb2072b2a7/#id72ceffbf-0c59-4d45-9e99-448dd05a11ae). Although that site is pretty sweet in general!

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MC_McStutter@reddit

Yeah, but the chance of breakthrough bleeding is more common, as the higher up the limb you go, the thicker it becomes and the harder it is to stop the bleeding. I’m sorry that you feel that way. I am.

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wasframed@reddit

Breakthrough vs unseen bleeds that kill. Hmm, definitely a lopsided risk analysis there. And I'm not sorry, considering your first reply you thought I was talking about fragments traveling post bullet-strike, shows either you're a fake or a terrible EMT/medic.

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Justhereforther34@reddit

If you’re in Care Under fire you would be correct. But considering you’re a civilian, you’re probably not going to be throwing hasty tourniquets on in a combat setting. Deal with the threat first, then throw on a deliberate TQ.

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TheRedBreadisDead@reddit

This, even for GQ scenarios stretcher bearers ran 2-3 (measure with fingers) above the wound.

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CockpitEnthusiast@reddit

That's a hasty tourniquet, which is definitely the rule of thumb in combat. Outside of combat 2-3" is plenty sufficient, so long as it has sufficient space from the nearest joint. if there's not enough space from the joint, go above the joint

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Euphoric-Recording70@reddit

That tourniquet needs to be higher 😅

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HonorableAssassins@reddit

Its high enough over the knee to seal, its over three inches above the injury. Let me guess, you didnt actually pay attention to *why* you were told do to high and tight for hasty tq's in class?

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Euphoric-Recording70@reddit

I just always heard that you want it as high as possible on a leg injury to stop as much blood flowing into the extremity as possible. But if 3 inches above the injury is good enough than great!

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HonorableAssassins@reddit

Its about wound assessment. If the limb is covered so you cant see where all the wounds end, you place it as high as possible incase there are hidden injuries beyond the one youve discovered, then continue treatment, examine the whole leg, and move your tq to three inches above so that if anything goes wrong, less of the limb is starved of blood. This means, in a worst case scenario, more of the limb can be saved if amputation is required, and thenmore limb you have, the easier it is to get prosthetics working better. Big difference betweeb losing a leg above the knee vs below.

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Euphoric-Recording70@reddit

Definitely, thanks for the input.

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Need_vagina_pix_nao@reddit

I forgot all about writing down the time when the tourniquet was applied. Thanks for posting this public service announcement.

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175-grams@reddit

Just put a thumb in it

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aziatsky@reddit

you dont “apply” dressing. you cram that shit (gauze) in the hole (wound) as deep and compressed as you possibly can.

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big-wangers@reddit

I thought tq went first

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HonorableAssassins@reddit

Depends on context. If its a gunshot, in combat, tq first because if excessively limited time/danger. If youre fairly safe, you can pack and then tq. Personally id probably still do a tq first just because its faster to deploy but civilians tend to have an aversion to them because everyone thinks theyll like immediately destroy the use of a limb or other dumb shit.

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Brother_YT@reddit

Instructions unclear. Tourniquet applied to neck for head wound.

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Medic7816@reddit

This will stop the bleeding and no further treatment of the patient will be necessary.

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KlutchKickem@reddit

High and tight

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oh_three_dum_dum@reddit

If anyone is interested, there are downloadable publications from the committee on tactical combat casualty care [here](https://deployedmedicine.com/market/11)

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DrinkMoreCodeMore@reddit

What's everyones favorite tourniquet to use or trauma response kit they carry?

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JoshuaGraham45@reddit (OP)

https://www.narescue.com/combat-application-tourniquet-c-a-t.html This is what I carry

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HazeGreyPrepper@reddit

If you don't have a tourniquet in your EDC kit, you're gambling with your life if shit goes down.

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Cerberus73@reddit

Way more likely to need the TQ in normal life than your bullet pusher.

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HazeGreyPrepper@reddit

Never hurts (no pun intended) to have both, just in case.

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JoshuaGraham45@reddit (OP)

I carry a tourniquet and two Israeli bandages. Can never be too prepared

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HazeGreyPrepper@reddit

I ordered tons of supplies from Chinook Medical and have at least 5 in my house alone. Two are in my Range Blowout Box.

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appleton123@reddit

These should be posted in schools!

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armedsquatch@reddit

A good blowout kit is a must for the range bag. Great post. I know so many avid shooters that never bring a kit when they go shooting miles away from anything

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moving0target@reddit

Go to the class, folks. It's worth it.

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TallMikeSTL@reddit

I do the stop the bleed class annually. Great program

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CockpitEnthusiast@reddit

An inner thigh arterial wound is so fuckin hard to stop the bleed. I had no idea how hard it was until we had a test dummy that measured pressure and blood flow. I as a 200 LB man had to completely pack the wound, place my hand on it for pressure, then kneel on that arms elbow to put ALL of my body weight on it. Not a single smaller female was able to stop the flow purely due to their body weight. I can't even imagine being on the receiving end of that, I'd probably rather get shot again

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