Originally Posted By emsjeep:
The only thing you can't improvise is a hemostatic agent, and those may not be in protocol everywhere and have a varying risk of thrombi.
A commercial tourniquet will hurry things up, which is good, but a pen and a strip of fabric is good too. You need training, especially if you have to justify your treatment decisions when things don't work out.
An improvised tourniquet may work, but it is not guaranteed. I have more than one picture of a soldier with "boy scout" tourniquets applied in the early years of Iraq and A-Stan. Those pictures were taken on the Medical Examiners table. I would rather spend the $30 and have the right tool to the job the right way.
I can improvise a chest seal better than a TQ. A nitrile glove, wrapper from your Normal Saline bag, just about anything can be used as a proper chest seal.
The only hemostatic agent that was pulled due to risk of a clot was WoundStat. It had 100% survival and kept bleeding under control for hours in the USAISR Hemostatic study, it was THE BEST hemostatic agent and it was pulled. If there were others that caused a risk I am sure they would be pulled.
Originally Posted By Country_Boy:
We found some velcro cable ties (1" wide with a black plastic buckle where the free end makes a 180 turn and sticks back on itself that we bought for a mass casuality kit. The reason EMS isn't so fast on TQs is in the civilian world, 99.9% of the time there are multiple responders (a bystander or LEO can hold direct pressure, though we don't want someone without first responder training doing it.) per patient. When there are multiple patients per respnder, responders have other critical duties, or the patient must be carried out, TQs are more likely to be used.. In EMS you rarely need a TQ other then an amputation. Having said that everyone is NOW trained that a TQ does not mean the limb is written off.
Anyway, when applied by a healthy male responder the velcro ties will work. Not tactical, and each one only has about a 40% range due to the velco mating. What fits a petite 1st grader would not fit a big obese 3 grader. Cost was $1 each. Ordered from Mcmaster. Hopefully we will never see if they work.
For a kid this would be great, try to find a wider version. For an adult you will see varied success with this implementation (see above)