Everyday Carry Pocket Dump of the Day – Roland

Tourniquets are actually overrated and have been largely discredited for domestic purposes. In a war zone… yes absolutely with mitigating factors but even then tourniquet is a last resort if medevac or casevac can’t be mobilized.

A pressure bandage such as the Israeli bandage does it all for a gunshot wound. He is smart to carry one. I do as well.

I was a CLS (40 hour trauma course every year for 5 years) in the Army and treated combat casualties and have 2 cousins and an uncle that work in EMS. As always though YMMV.

4ID:

First, off this guy is carrying a gun. That means he expects gunshot wounds. How does a gunshot wound in a mall differ from one on a battlefield? It basically doesn’t.

““Tourniquets are actually overrated and have been largely discredited for domestic purposes.” Source with statistics please. Also, provide such a source for gunshot, car accident, crush and blast victims who don’t receive EMT level medical aid in the first two-three hours.

Second, numerous other things that are common in civilian life can require a TQ. Compound fractures and other puncture wounds due to a car accident come to mind. In civvie life these types of injuries are common due to the crushing of extremities in car accidents. You’re not dealing with someone who’s arm is crushed from the mid upper-arm down with a pressure bandage or any other mixture of pressure and hemostatic agent. It requires a TQ. I’ve personally seen such an injury due to a car accident.

“A pressure bandage such as the Israeli bandage does it all for a gunshot wound.”

Unless of course it doesn’t. Trauma too big to a leg or arm where a major artery is punctured or destroyed in multiple places and you can’t find it comes to mind. So does a gunshot wound causing pneumothorax or a gunshot wound where you can’t get that bandage to stick. What about multiple serious gunshot wounds? Someone with one in the chest and one that clipped the brachial artery or another that nicked the femoral?

I’m not trashing the guy for carrying an IB, I carry them too, my point is that it’s an interesting decision for someone who’s clearly thinking about a gunfight, as evidenced by his carrying of a gun, and chooses to carry a single piece of gear like this especially in the light that he also chooses band aids, a single use hand sanitizer and some pills.

No disrespect but I’m not going to do that leg work re: sources just to validate an opinion I reached by reading numerous medical journals, text books and websites as well as practical knowledge learned treating combat casualties in Anbar and Sadr City. There is simply too much there.

Re: state statistics for gunshots, car accidents, blast injury victims that don’t get EMS level care in the first 3 hours. Where do you live? I am within 20 minutes of a trauma center everywhere I travel in a normal business week and I am in rural/suburban GA.

I will state that I have seen several men shot several times with intermediate rifle cartridges in the torso and extremities and never used a TQ. I have used multiple pressure bandages on top of packing the entry/exit wounds however to great effect.

As far as pneumothorax is concerned are you going to perform a tricky procedure on someone you just shot, an innocent bystander or yourself? All 3 seem improbable to impossible. I have performed 2.

There is a reason they call it the golden hour. If I have been shot multiple times in the torso with a pistol I still have an hour to get to a trauma center before I am in trouble. Gunshots don’t work like the movies. EMS should be able to get you there within an hour, we’re not in Baghdad here.

All that being said I do carry a pocket IFAK with me and have the knowledge to use it and so should the above pocket dumper. There are VERY limited and specific uses for a TQ but a car crash, shooting or any other common occurrence I can think of isn’t it. A terror attack/explosion? Yes. Only because that is going to be a MasCal event with lots of partial or full amputations.

YMMV!

4ID:

You don’t have to provide the stats. The fact that you bother to respond tells me you’re likely honest.

“I am within 20 minutes of a trauma center everywhere I travel in a normal business week and I am in rural/suburban GA.”

I live in Colorado but frequent places in this state and others where just getting out a call for help in a serious emergency such as a rollover could take over an hour if you’re restricted to foot and God knows how long for EMS to arrive on scene. I can think of two dozen camp sites I really like that it would be hours for them to get there because they’d either have to drive 90 minutes AND find you or land a helicopter miles away and hike in or some combination of the two.

I’m not going to get into a lengthy discussion of this because it covers way too many things all of which can be “what if’d” to death but the point remains; civilians are also susceptible to injuries that may require a tourniquet if EMS can’t be on scene immediately. Not everyone lives within 20 minutes of help or spends their whole life there. The assumption that a torniquet is “overrated” is based on the idea that help is minutes away and that the injury isn’t going to result in exsanguination within a few minutes. If one or more of those things isn’t true then that assumption goes out the window.

I’m not going to even get into the concept of a major terror attack a la Paris because again, that would cover way too much. Suffice to say in such a case SOP these days is to secure the area and search it for traps before allowing EMS in to start treatment and that takes time people who are bleeding out don’t have.

Just look at the med kit a serious gun range has. CATs, Israeli Bandages, Cellox, a decompression needle and HALO seals are standard these days.

I respect your opinion based on your CLS training, but it’s not a 1:1 correlation to civilian circumstances by any means and in neither case is rapid medical attention exceeding what’s available now a guarantee.

Again, I’m not trashing the guy, I just find it interesting he chooses to carry and IB given the other items he chooses.

Since this is TTAG, here’s ‘Lawyers, Guns And Money’:

“Send lawyer, guns and money – The shit has hit the fan!”