What are the odds of needing a gun for a defensive gun use? Assuming you avoid stupid people in stupid places doing stupid things, it’s lower than a snake’s belly. So why carry one?
Because if you need it, you really need it. Meanwhile, what about carrying something that you’re more likely to need? Something that, again, can save your life and the lives of other people?
I’m talking about a tourniquet.
If someone is bleeding from one of their extremities — arms or legs — you need to stop that bleeding fast. The amount of time before a human will bleed out and die depends on whether or not it’s arterial bleeding, and which artery is compromised.
If you’re leaking from arteries like the Dorsalis pedis, you’ll have a few minutes. If you’re spurting blood from a major artery you could become unconscious in under a minute. You could bleed out in three to five minutes.
There’s only one way to not die: stop the bleeding. You can plug a hole — but you can stop the bleeding more quickly than that. With a tourniquet.
As our resident war hero Jon Wayne Taylor pointed out in his excellent article Combat Medic: The Work Really Starts Once You’re Shot, one tourniquet will cover about 80 percent of injuries. (Click here to former EMT Nick Leghorn’s article on first aid.)
The other twenty percent will benefit from the application of a second tourniquet. (If the patient’s still bleeding after the first, apply the second further up, closer to the heart.) Not to mention the possibility that the first tourniquet may break.
Dr. John Holcomb at Brooke Army Medical Center proved that most of the tourniquets being used didn’t work effectively. Your belt? A torn T-shirt and a piece of wood? OK, but there’s nothing as effective as proper tourniquet.
Jon recommends the SOFT tourniquet.
Carry two of them in your range bag. I keep two in my car. And two in my home. Some gun guys — especially hunters — have one attached to their rifle stock with a rubber band. Bad idea. Put it in your pocket or somewhere on your body.
Learn how to use a tourniquet, and how to use it fast.
It’s always best to get some kind of trauma care instruction, but applying a tourniquet isn’t rocket surgery (just don’t use it on the neck). Put it as far up the arm or leg as possible (veins retract when they’re severed) and twist the living sh*t out of it.
If you or your patient scream in pain as you twist, awesome! I repeat: this will be incredibly painful for the patient. That’s normal.
Then transport or get help immediately. Don’t worry about someone losing an arm or leg. JWT: “I’ve had patients with tourniquets for over 10 hours without long-term tissue damage.”
[NOTE: there are some states (e.g., Texas) that protect their citizens from lawsuits if they attempt to save someone using reasonable care. Not that it should stop you, but check your state’s law.]
How many times have you seen someone who’s been shot? How many times have you been in or seen automobile accidents? I willing to bet a lot more often. What good will your gun do in the latter situation?
I heartily recommend carrying a firearm for personal protection. But having a couple of tourniquets at hand is more likely to be the difference between life and death – for you or someone else. Why not have access to both?
[Special thanks to Tactical Fitness Austin and TTAG writer Ron Grobman for his most excellent Trauma Care and Rescue class.]
Fun fact: This may be excellent advice, but most of us won’t follow it. Most of us won’t carry tourniquets. And many of those who do, won’t spend the few minutes it takes to learn how to use one.
So – How about some practical advice? Like for instance, most of us dudes wear leather belts. Could you whip it off your pants and use it as a tourniquet? If so, how? What are some other common items that could be used? Telephone cords? CAT-5 cable? The shirt off your back?
Inquiring minds want to save lives, even if we’re lazy and complacent the rest of the time.
Anything less than a SOFT tourniquet is less. A LOT less. Have one handy whenever possible.
N.A.R. CAT, battle dressing, and maybe a chest seal
On this one, I’m still screwed. I have a steel core belt.
Whether you realize it or not what you’ve just said here is that a few minutes of your time isn’t worth your life or the life of another person, possibly a loved one. Are you really so caviler with your own life and that of others?
I guess a CPR/AED class is completely out of the question…
I took a CPR class. More than once. I took a class on how to use the idiot-proof defibrillator hanging on the wall in the hallway of the office building. I have since forgotten most of what I learned and will do my best when the need arises.
Truth is, I have more life-saving skills than most. I have experience making decisions in crisis situations. When the $h!t hits the fan, I’m mentally and emotionally prepared better than most people who have never been to war or worked as an EMT.
It’s not about a few minutes of my time. Take that sentiment and shove it. It’s about a lifetime of decisions that have led to the ability to enjoy a lifestyle that is safer and healthier than the majority of Americans.
I’ll not judge those who carry a tourniquet in their pocket. And a knife, and a gun. And a bottle of epinephrine, and a chest seal, and and a tracheotomy tube, and anti-venom for the seventeen most populous species of poisonous snakes and insects. But eventually you run out of pockets and realize you’ll need to buy an Ambulance to haul around all the $h!t you might someday need to save someone’s life.
I’m thinking my EDC bandana and aluminum pen light would combine to make a decent improvised tourniquet. Tie off bandana around leg or arm, slide aluminum flashlight underneath, grab light and twist. If you’re the type who wears a neck tie often (I’m not), that might work too, combined with a sturdy pen if need be.
I will consider a tourniquet for my car kit, but I’m not carrying that around in a pocket.
I get your point BUT the point of this article is that, while many of us carry a gun despite the infinitesimal chance we will actually ever need it, a tourniquet is a simple piece of equipment that is MUCH more likely to be needed and yet is much less likely to be carried.
“It’s not about a few minutes of my time. Take that sentiment and shove it.”
I didn’t say it. You did.
I’ll assume, in deference to you, that your OP wasn’t you talking about yourself when you used words like “us” but rather talking about other people in a general way.
As for carrying “stuff” if you need a vehicle to carry around a few ounces of stuff… well you don’t so the argument is invalid. When you get into this kind of exaggeration you undercut everything else you have to say.
If you think an improvised tourniquet is going to work/do the job/is better than nothing then perhaps something by Nerf rather than S&W/Ruger/Gluck.
I’ll just use my wang as an improvised tournequet,
Can’t use my belt, my gun would fall on the ground.
Because research has shown that the vast, vast majority of times belts do not work. They just don’t put enough pressure to be effective tourniquets.
I have always been in favor of multi use objects. Things I can use for lots of stuff. Although I’ve never seen it, I would bet electrical tape would make a good tourniquet. I’ve put amazing amounts of pressure on all kinds of things with it.
Would I bet MY life on it? Well, I have some in my first aid kit, and I don’t have a tourniquet, so I guess the answer is yes at the moment. I’ll probably pickup a couple tourniquets someday though…..
It might work, but sure don’t bet a life on it. A better alternative item would be the thicker duct tape (90 MPH tape). Double it over on itself and it has 100 lbs of tensile strength.
Rookie. Spray on some Flexseal on the booboo and then the duct tape goes on top.
NEIOWA, I realize that this conversation has already gone into the absurd but I was not referring to placing the duct tape over the wound. I was giving a method of manufacturing a duct-tape-tourniquet for emergency use.
As for flexseal, you’re not too far off even in jest. I’ve heard and read that superglue was originally designed to patch together broken Soldiers in Vietnam.
The issue with simply using a topical solution and not compression is that the arteries under the skin and tissues are still able to exhaust your precious supply of blood. Get that tourniquet high and tight in a life/death situation and evac immediately.
Yeah fuck tourniquets! I’ll just carry a bottle of liquor around do give to anyone bleeding out!!!
I’m gonna carry a propane torch around so I can cauterize it!
Curtis, those items mentioned are okay as alternatives; but they are slow, much less effective, and require critical thinking skills that simply are not present in the heat of a life threatening situation… especially if the one injured is yourself. A CAT or SOFT is incredibly fast and easy to use. Just diagnose the bleeding as severe, apply, tighten, check the bleeding again. It takes a minute if you haven’t practiced and the packaging is still on, 30 seconds is a reasonable expectation if it is self applied and you’re somewhat proficient.
I beg you to consider it as an option, even given your initial thoughts.
I recently completed CERT training (Community Emergency Response Team), and just today, I ordered some triage tape, which got me thinking: in an emergency, can I use triage tape as a tourniquet (assuming it’s strong enough)?
If so, would I use the RED one (red stands for IMMEDIATE care needed or the person will die), or the YELLOW one (yellow means delayed) on the assumption that if you stop the bleeding with a tourniquet, they’re no longer in the “immediate” category?
Again, I just ordered the triage tape, so I won’t know yet whether it’ll be strong enough to use as a tourniquet until it arrives, probably not, but it would be nice if triage tape were dual-purpose because I’ve already spent a lot filling up my CERT bag with necessities. I already used my new CERT training once, when I was first on the scene after a man got run over by a car, but I lacked the triage tape then.
Here’s an idea: buy two tourniquets.
Hey, I have an idea- I often chew gum. Lots of gum. I always have gum on me, or in my mouth. Gum can be stretched to form a string. Can I use gum string as an emergency tourniquet? /Sarc/
Only if you have undergone extensive MacGyver training!
Triage tape isn’t strong enough get a real tourniquet. As a Cert person you have reason to have a robust kit.
You have to use the black tape because they will be dead by the time emt shows up if you are trying to use the tape as a tourniquet. Seriously tho not a good idea
I do carry a tourniquet with me at all times, as do probably most people reading this. It has a secondary role keeping my pants above my hips when not in use.
Here’s a better idea: carry two SOFT tourniquets. Or at least one.
So if you use it you end up wearing your pants like a gangster and then what do you attach your holster to?
If I am using my belt as a tourniquet, keeping my pants up is probably very low on my immediate to do list.
I have a CLS bag in each car and one for the range, have used them multiple times from the extreme of a car accident to the mundane of a cut finger. Above a gun in my priorities of carry(although I carry one too)
It’s not going to work. Belts rarely make effective tourniquets.
JWT – Would a para-cord bracelet or key bob and a metal 2-AA cell battery flashlight be enough for a serviceable tourniquet?
I would have said flash light.
A close second?
I second that. I started carrying a small flashlight when my wife and I got our dog (for those nighttime walkies!) and shortly before I obtained my CCW. And now I’m surprised that I ever got along without one.
I genuinely do not mean to be a dick but where in the blue hell are we supposed to carry all of this stuff? I already have a hard time fitting my keys and phone on top of my edc and I open carry. Where exactly am I supposed to carry 2 of these things on top of my lighter, flashlight, keys, phone, gun, spare mag, knife, OTHER KNIFE, wallet, etc.?
Oh, and if you’re wondering, no I am not old enough to get away with a fanny pack. So don’t say it.
My solution isn’t ideal, but it’s the best I can do. I’m a minimalist at heart, but like to be prepared. So I have a backpack with all kinds of stuff for all types of emergencies. It’s always within 50 yards of my position.
On body, I carry keys, light, wallet, phone, knife, gun. I wear a cotton undershirt, which could double as a lot of things if needed.
Buy pants with more pockets.
Jeez, that’s actually what I did! 3 pockets left are spare mag, cell phone, and coins, chapstik, knife, etc. 2 pockets right are car keys (remote style), empty (covered by holster), left rear wallet, rt rear temp storage of most anything. But several years back I discovered I did not have enough pockets, completely changed my “wardrobe”, as in so slovenly my bride sometimes pretends she doesn’t know me. And I STILL don’t have space for a tourniquet. Guess I’ll just die. We are all going to.
Duct tape it to your hat along with a triage bandage.
You’ll start the new cool trend.
Take out the extra mag and other knife and you will be good. Prioritize
Robert has some good suggestions about where to carry them in the article.
I’ll take a crack at a serious explanation based on what I do personally.
I carry a pistol at about 4:30-5:00 in an IWB holster. I carry a Fenix PD22 flashlight, which I highly recommend, clipped to my right front pocket (it comes with a clip) right in front of my knife. Spare mag is carried horizontally on my left hip. Keys in my right front pocket when not in use, wallet in my back right pocket. That’s pretty much my “on person” carry.
I’m in school so I carry a backpack, in this case an Oakley Mechanism pack. It has a pocket on the front of it where I put a 7x5x2.5 FA case I scavved off an old first aid kit. That kit contains your usual FA boo-boo stuff, plus a CAT, meds, triangle bandage and a 4″ Israeli Bandage. Next to it I put a 6″ IB and a second CAT. Total weight, 26oz. Since I carry books and a laptop around with me the weight is negligible.
Really your ability to carry a bag of some type will be based on what you do in life. Around me it’s very common for people to simply carry a technical type pack even if they work in an office building. If you can carry a bag of any type you can add some CATs, shears and IB’s for less that a pound of added carry weight.
It depends on the industry, some places let you get by with a back pack or suitcase in which case a good first aid kit can be a small, light addition.
The Fenix PD22 is a nice light, but it has one serious shortfall IMO, it’s CR123 *only*, if memory serves.
They make one that uses 1 AA alkaline that is more utilitarian, as it’s a whole lot easier to find a AA in a pinch…
A “tacticool” brief case/satchel has come in mighty handy for me. Laptop, first aid kit, back up gun, mad money, emergency food ration, couple MSR mags, etc. Endless possibilities. Fits behind front passenger seat in floor of my vehicle.
Lose the skinny jeans…
I would have said brain!
I’ve been at more places with copious amounts of bodies and blood than I care to think of and if you don’t think all the fancy equipment in the world is useless.
Strap it to your tactical vest/plate carrier.
Robert, hoping you or JWT can comment on the key differences between this particular tourniquet and the more common CAT Tourniquet, which a number of us carry. Looks very similar in principle, but the design does appear a little bit different here and there and I am curious to hear comments from people that have used both. Thanks much
I think one of the larger differences is that the the SOF-T has a metal windlass, and the CAT has a plastic windlass. Some of the fittings on the SOF-T are meal as well. Perhaps the width of the compression strap is wider, depending on the variant of SOF.
No that’s pretty much it. Although there are some other small differences it’s that metal bar that makes the biggest difference. I’ve snapped the nylon bar on the cat several times on the legs of patients.
20 or 30 years, JWT, you’re going to discover you’ve led an interesting life! Salud!
Thanks for the replies.
Chances I’ll be in a DGU? pretty damn low
Terror attack? pretty damn low
Fire? pretty damn low (but I still have a fire extinguisher at home)
Bike or motorcycle accident with a mangled leg or crushing chest injury? pretty damn low.
I still carry at least one CAT (soon to be a SOFT) tourniquet. When I can, on the motorcycle, with cargo pockets in pants and jacket I have two each of CAT, Israeli bandage, chest seal, 14 gauge angios for chest decompression.
Not because I think I’ll need them. But because if I do and I don’t have them, the results could be catastrophic. Same reason I carry a handgun.
Know your laws for sure. I don’t consider this a secondary consideration. While everything you do may be the very definition of selfless and caring it can still completely ruin your life if the person you assist is a stranger and a lawyer gets involved later. You want to know what’s what going in and how to obtain legal consent to treat someone. Screw this up and it may completely upend your life when you were doing the right thing.
Also, just having this stuff isn’t useful if you don’t know how to use it. You’re not going to be reading the instructions and “learning on the fly” when someone’s screaming and bleeding out in front of you. FFS get acquainted with this stuff before you need it. I had a situation where I gave someone a fire extinguisher and told them “Put that fire out”. They just stared at me, so I took it from them and did it myself before doing anything else. I later found out that they had no idea how to operate a fire extinguisher (Jesus, really?) and the idea of reading the giant instructions (with pictures!) on the side of the thing was a bridge too far for them at that moment.
You would be amazed at how many people’s brains just shut down in emergent situations.
Want an experience sometime? Drive an ambulance or fire truck through traffic to the scene or the ER.
Darwin had this theory about “survival of the fittest,” that the smartest, most adaptable organisms would prosper and those that could not adapt or were too stupid to adapt, would go extinct.
After you drive a fire truck in traffic, even in a small town, you will come to the conclusion that Darwin was wrong.
At EMS scenes where there’s a gaggle of people, I’d break down the population about like this:
40% barely know what is going on. They’re rubbernecking, but doing absolutely nothing to help, not asking any useful questions, like “If I can’t do anything useful, should I leave?” (the answer is often ‘yes’)
40% are running around in circles, “who should we call, what should we do?” They want to be helpful, but they have utterly no clue where to start.
About 15%, depending on the crowd, know they should be doing something, and they’re trying to sort out what to do. Find and recruit these people on scene to deal with the 80% above.
Maybe 5%, or one in 20 people, have a clue what to do, and sometimes, they’re doing it, doing it well and making you wonder “why did someone call me? This person is handling this like a boss!”
Upon talking with this small percentage of people, I find out that they quite are veterans of our armed forces. Sometimes, they’re retired FF/EMT’s, or they were/are RN’s, MD’s, etc. – or they’re one or more of these past qualifications (eg, retired FF/EMT who also was a Marine – right there, you’ve hit the jackpot).
Most of the public is now useless. Assume this going into any emergency incident, especially a medical one. It didn’t used to be this way, but here we are.
It has also been my experience that The Closer you get to a large population Center, the smaller of the percentage of that useful group you find.
I think it’s more a volume problem, bigger city more people the more people you meet in the 80% but I think the percentage is still correct.
I have to agree with that assessment.
People who don’t know which end of the socket wrench is the handle are generally useless. It’s not necessarily that they don’t want to be helpful but they have absolutely no knowledge base for anything that’s actually useful. There’s a higher concentration of these people in a city.
People freezing I get, but a 40 year old man who doesn’t have any idea how to even start to use a fire extinguisher? I was shocked but that was his problem. I might as well have handed him a transmission and told him to rebuild it, he had no clue how this thing in his hands worked, almost like he had never seen one before.
The pathetic lack of useful skills among my urban and suburban friends amazes me. I know people who will take their car to the dealer for service if it has a low tire. They’ll call a plumber if their sink faucet leaks a bit. I have no doubt their first aid skills aren’t any better.
This is what happens to people who depend on government to provide their every need. If the grid ever goes down, I hope I’m a long way from a metropolitan area when it happens.
“You would be amazed at how many people’s brains just shut down in emergent situations.”
I read a fascinating book on that very subject a few year’s back, ‘Unthinkable: Who Survives When Disaster Strikes – and Why’ – by Amanda Ripley.
It goes into that subject in some depth, primarily from her interviews with folks who survived mass tragedy.
It’s like a herd mentality that sets in, to the point where they just go along with whatever the crowd is doing, to the point of just doing nothing and waiting to die.
Here’s one line from it, from a guy who survived the WTC Sept 11 attack:
“From beginning to end, Lesce was held up by the people around him. When I ask him what he would have done if he had been alone on the eighty-sixth floor, he says he doubts he would have made it out. “If no one had been there, I would’ve wet my pants. I would’ve yelled. I would’ve done whatever I possibly could to communicate with somebody. Then I would have sat there and waited to die.”
It’s well worth the read…
no, Darwin was correct. The hipster pajama boys in Manhattan and Silicon valley are highly adapted to their environment. They have adapted to living in a hive and not having to lift anything heavier than a Starbucks Vente, and if they get killed it doesn’t matter because they weren’t going to reproduce anyway.
I carry a 4 inch Israeli bandage with me everywhere, in case you are not familiar with it, it can be used as a bandage, tourniquet and the two wrappers can be used as a chest seal.
You will find few people on this planet with much more experience than me on that particular dressing. It’s a great piece of equipment. Everyone should have a few. It is not an effect of tourniquet.
It looks like a useful bit of kit, but it looks too wide to be an effective tourniquet. Pressure dressing? Heck yes. Fast way to stop an arterial bleed-out? I dunno. I’ve got the same question with the SWAT rubber pressure dressing.
I used to carry a couple of CAT’s in my EMT bag and in my shooting bag. Upon JWT’s advice, I went and purchased a couple of the SOF-T’s and just added them to the kits. It isn’t as tho they go bad.
This is one reason I not only wear a 2-inch cloth belt but also carry an extra in each of my backpacks.
Small rags in small holes, big rags in big holes, tie off anything else.
What’s the best tourniquet to staunch a neck wound?
Is the unfortunate Nancy Pelosi? So sad. 3/8″ hemp
Since she is necrotic from the neck-up due to botox overdose, she’d never notice one way or another…
A really tight one.
I bought three tourniquets during a sale on Amazon. I gave one to a friend, one goes in my chest rig, and the other goes in the truck. I don’t carry one on me, but it is nearby if I need it.
I carry (everyday – everywhere) pretty much what JWT recommended here a couple years ago, including the ranger medic book. I do only have two SOFTT-NH tourniquets. I keep meaning to get some more, especially a wider one. If most saw my EDC on that EDC website, I’d likely be ridiculed for going overboard. I have three types of clotting agents, a couple chest seals, 3 Israeli bandages, and lots of gauze among other things.
If we carry everything we might need in our pockets, how about using the suspenders you would need to hold up your pants?
You pants might then fall down, and you could practice being a thug.
we can sit here all day and list things we COULD need but its not realistic to carry EVERYTHING you need. or even half of what you MIGHT NEED during after a gun fight. Calm your OCD people, you can’t control everything.
A towel is the most massively useful thing a person can have.