Tourniquet - military vs civilian

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Wouldn't that depend to a great extent on the amount of injury to the
limb from the original injury that caused this "barely controllable"
bleeding?

When we claim that the body will respond a certain way to an
intervention, we are often surprised by the uncooperative nature of the
human body.

Many evaluators, in response to examinee treatments, will state "You
killed the patient." 

The reality is that some patients survive with out apparent sequelae
following horrible mismanagement, while others seem to have everything
going for them and die.

When you think you can predict how much damage you can cause before it
becomes irreversible, you are fooling yourself.

The point is to keep as much adequately oxygenated blood in the patient
until there can be definitive treatment - surgery.

Tim Noonan.


On Sun, 04 Dec 2005 19:42:16 -0500, jenw133 at aol.com said:
> While we're on the topic, can anyone tell me a rough estimate of the
> length of time a tourniquet is on where the extremity will not be able to
> survive? (Assuming of course that it is applied appropriately...)
>  
>  
> J. Warden
> EMT-P 
>  
> -----Original Message-----
> From: Ashton Treadway <napthene at gmail.com>
> To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
> Sent: Sun, 4 Dec 2005 13:09:57 -0800
> Subject: Re: Tourniquet - military vs civilian
> 
> 
> Apparently you missed this part of Dr. Boylan's message:
> 
> > Capt Mat Boylan
> > Medical Officer
> > 2 PARA
> > (The iraqi desert!)
> 
> Ashton
> 
> On 12/4/05, DocRickFry at aol.com <DocRickFry at aol.com> wrote:
> > In a message dated 12/4/2005 3:23:13 AM Eastern Standard Time,
> > boggy556 at hotmail.com writes:
> >
> >
> > > I think we should be careful not confuse the civilian and military
> > > pre-hospital environments here. Just as it is often inappropriate to apply
> > > many in-hospital emergency trauma research to the pre-hospital environment,
> > > the same applies between military and civilian environments.
> > >
> > > In the civilian pre-hospital environment the tourniquet should NOT be the
> > > first method that is used for haemorrhage control. The civilian pre-hospital
> > > practitioner is in an environment where it is possible to apply the basic
> > > (and frequently effective) methods of heamorrhage control - direct pressure
> > > dressing /elevation/ pressure points / evacuation. Tourniquets may be used
> > > when these measures fail to control haemorrhage, because they DO carry an
> > > associated morbidity. I do however recognise that there are situations where
> > > a tourniquet may be an appropriate first line in the civilian environment -
> > > SWAT, Snatch rescues, etc.
> > >
> > >
> >
> > Before you pontificate so heavily on the military environment in Iraq without
> > having been there, you need to address these points to those who have
> > published on this and have found tourniquets of great value, and WITHOUT all 
> those
> > bugaboo problems that dogma would have us believe.  Armchair quarterbacking 
> like
> > this should go only so far--maybe you actually have a thing or two to
> > learn....????
> > ERF
> > --
> > trauma-list : TRAUMA.ORG
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> >
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