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The following are the basics of buying tourniquets for the police and quick tips for successfully applying tourniquets to control severe limb bleeding
This is the first article in a three-part series of articles on tourniquet application to prevent severe bleeding written by the SWAT team leader and nursing staff. Part 1 introduces basic tourniquet selection considerations and success secrets. Part 2 introduces tourniquet training. Part 3 introduces advanced techniques for using tourniquets in the real world.
Jason Williams and Brian G. Anderson
Tourniquets have become standard equipment for most law enforcement officers and have proven to be an important tool for controlling life-threatening limb bleeding. In some cases, a police officer may be present when there is a life-threatening limb injury and is the only person who can quickly control bleeding and save lives. Just as solid skills are required in other high-risk activities, the level of skill in the use of tourniquets can have an impact on the survival of officers or bystanders from severe bleeding.
The tips in this article are based on experience with military-grade North American rescue combat application tourniquets (CAT) and TacMed Solutions SOF tourniquets, but most of the tips also apply to other tourniquets.
There are two items on your uniform that can save your life, your pistol and your tourniquet. Simply put, pistols are used to save lives, and tourniquets are used to save people. If you want these two tools to be effective, both tools require professional skills when operating under pressure.
Choosing a tourniquet for individual or entire department use is an important decision and should be based on professional research and evaluation. Fortunately, anyone responsible for making this important decision has access to research and advice. The Joint Trauma System of the Department of Defense (DoD) includes a team responsible for evaluating the equipment that will be used in combat. One such group is the Tactical Combat Casualty Care Committee (CoTCCC), which is responsible for recommending tourniquets.
The selection of equipment/tourniquets included in the CoTCCC recommendations can provide officers with confidence that the tourniquet has been evaluated and meets the requirements of the U.S. military for use on the battlefield. For more information on the tourniquets recommended by the CoTCCC, please read "New TCCC Guidelines Provide Officials with More Tourniquet Options".
Although tourniquets are simple devices, manufacturers will make improvements to improve their design and effectiveness. Before purchasing a device, it is best to check the manufacturer's website for the latest version/generation available.
Before switching from one tourniquet to another, an internal evaluation is appropriate and the best option can be drawn. Fortunately, tourniquets are inexpensive, so internal evaluation costs are reasonable.
Traditionally tourniquets are black, but there are also orange and blue tourniquets. Blue tourniquets are usually designated as training tourniquets, and their blue color helps separate them from the tourniquet in use.
A high-visibility orange tourniquet is also provided, which has advantages over traditional black tourniquets. Orange high-visibility tourniquets are more likely to be noticed when treating multiple victims at the scene of a shooting incident or any other incident involving multiple victims. Knowledge of tourniquets may affect the time it takes for the victim to be removed from the scene. When multiple victims arrive at the hospital or trauma center, the orange tourniquet will stand out and be noticed by hospital staff who are quickly handling multiple victims.
The tourniquet is a single-use item because the structural parts will be stressed during use, and the tourniquet may be contaminated with blood and other potentially infectious substances. Purchase spare parts for replacement.
Finally, shop cautiously. Counterfeit tourniquets have been on the market for many years and continue to cause problems for unsuspecting buyers. The threat to public safety is so serious that it has become national news.
To solve this problem, the Food and Drug Administration (FDA) issued a notice to warn the public about the issue of counterfeiting. In the case of CAT, some fakes look almost the same as the real CAT, and may be recognized as fakes based on images showing the details of the fakes.
In one example, the structure and sewing method of the fake CAT can prevent the tourniquet from tightening. When buying a tourniquet, it is best to buy it directly from the manufacturer’s authorized dealer or distributor.
After choosing the tourniquet used on duty, you should choose a box or stent that can accommodate the tourniquet. Tourniquets are becoming larger and larger, so when choosing a stent, it is important to verify that the tourniquet and stent are compatible.
Regardless of the type of situation used, the tourniquet should be able to be deployed when the officer’s hands are wet from rain, sweat, or blood. In the event of a tourniquet deployment, fine motor skills may be weakened, which makes the ease of deployment a key factor.
Boxes with lids secured with plastic buckles may become difficult to handle, so elastic lids or hook and loop lids are better choices. The elastic cover has a pull ring, but if the pull tab is too difficult to open, you can grab the entire elastic cover with one hand and pull it apart. Gear attachment options include simple belt loops and modular light load equipment (MOLLE) systems. The rigid tourniquet cassette can be with or without a flexible top.
A box installed in the front of the pistol holster has been developed to free up space on the watch belt or vest. Ankle sleeves are also provided. Before proceeding with all door purchases, check the compatibility of the box with the tourniquet and the connection options of the watch belt and tactical vest.
The officer’s uniform is already full of equipment, and it may be difficult to find room for a tourniquet box or stent. Before determining the location of the tourniquet and the retainer, it is important to determine whether the tourniquet can be reached and deployed with any of the officials' hands. Fixing the tourniquet bracket too far on one side may prevent your hands from reaching the other side of the body.
Here are five tips for successfully applying tourniquets.
1. Remove the plastic packaging. The plastic packaging that protects the fresh tourniquet in the factory can keep the tourniquet clean during transportation, but it needs to be removed before use. A life-threatening event is when there is no time to try to remove the plastic wrapper, especially when fine motor skills are impaired and the hands are slippery from blood or sweat.
2. Powder those gloves. Latex and nitrile gloves may be difficult to put on with slightly damp hands. Before putting the gloves in the glove holder, you can apply a little powder to the inside of each glove in advance. A travel-size powder container can be placed in the personal equipment bag, which can be used after gloves is used, and new gloves are required. Jumping over the powder in the gloves may cause the gloves to tear, and they will be thrown aside when they are needed most. If you can choose gloves, heavy-duty 7 mil or 9 mil gloves are thicker and more durable than lighter weight gloves.
3. It's like a cowboy's lasso. Before putting the tourniquet into its holder, the tourniquet should be set to be quickly attached to the limb. For example, when using CAT, the strap should be passed through the buckle to form a loop with the tail. The loop should be large enough to fit on a uniform shoe and slide onto the thigh, and the tail should be long enough to be easily grasped and pulled when it needs to be tightened.
4. Efficient vs. neat. When using the CAT tourniquet, the windlass (rod) is tightened and inserted into the windlass clamp. Then pull the windlass fixing strap through the windlass clamp opening to secure the windlass in place. If police officers often carry tourniquets and the anchor strap is pulled through the anchor clamp opening, the application may be delayed. In this configuration, after tightening the windlass to stop the bleeding, the police officer will have to hold the windlass under tension while trying to grab the windlass entrainment and remove it from the opening. A better configuration is to keep the windlass strap on one side of the clip. It doesn't look so neat, but it is more effective when efficiency is important.
5. Order of use. When setting up a personal trauma kit or personal first aid kit (IFAK), please arrange the contents in the order of the items to be used. When the bag is opened, you should see the first item you need first, then the second item, and so on. For example, first gloves, then tourniquets, then hemostatic dressings/bandages, etc.
Next article: Watch Police1's on-demand webinar to learn about the evolution of training for laid-off officers.
Jason Williams is a 20-year veteran of the Aventura Police Department in Miami-Dade County, Florida. Jason has been a member of the multi-agency SWAT team for 16 years and the team leader for the past 12 years. He is currently certified in a number of faculty areas, including active shooting response, low lethality, ballistic protection, mechanical/ballistic destroyer, etc. Jason has been a K-9 porter for 12 years, responsible for two dual-purpose dogs. His experience as a SWAT team captain/member and K-9 handler prompted him to become a better tactician and share his expertise.
Brian G. Anderson is a retired battalion commander and paramedic of the Miami-Dade (Florida) Fire and Rescue Team. Before retiring, he focused on the development of fire rescue active firing procedures and inter-agency active firing practice. He is a lecturer at Palm Beach State College and a volunteer lecturer at Trauma Training Group, Inc., an organization that provides free stop bleeding training in South Florida. He has provided bleeding control training to private, public, and charter school personnel, as well as members of city and county law enforcement agencies.
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