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Thu Dec 14 18:10:57 GMT 2006

I teach a lot of first aid classes and lately the sanctioning agencies AHA,
ASHI, etc.  have been moving away from three steps (direct pressure,
elevation, or pressure points)  to a single step, direct pressure.

I used to explain why pressure points were better than tourniquets. Now I
leave them with direct pressure only and with a troublesome bleed I know
they will move directly to a tourniquet.

On 12/14/06, oded private <tangentcarrot at hotmail.com> wrote:
>
> You're probably right, but I'm not sure you realize how far it's gone in
> some places. IDF soldiers- and I'm not talking just about medics- have to
> carry a perssonal bandage with them at all times. Many of them carry a
> tourniqet with them- forgetting all about the bandage, and sometimes don't
> even carry it at all. They hang out of their pockets in a fashionable and
> "operationale" matter- while they don't understand that if they pull it
> out
> unrolled- it's no good. One time an instrouctor in medic's course talled
> me
> she carried a tourniquet instand of a perssonal bandage -"like I could
> ever
> save anyone's life using a bandage". As I stated before- even lay rescures
> use tourniqutes. They don't know of any other way to controll hemmorhage.
> They don't understand that you can use manual pressure to controll
> hemorhage. I know of a case were a kindergarten teacher brought a very
> young
> child (3 y/o if I remember correctly) with a bleeding soft tissue injury
> to
> leg cuased by a piece of broken glass. By the time she got her to the ED
> she
> had exshanguinated. Noone working in that kindergarten thought they could
> control it simply by pressing on it!
>
> Just today I tought first aid class to lay rescures- when I said "now we
> are
> going to learn how to control external bleeding" (that's what I said- I
> didn't even ask a question) - someone immediatley said "tourniquets,
> right?"
>
>
> >From: bensonblues at comcast.net
> >Reply-To: "Trauma & Critical Care mailing list"
> ><trauma-list at trauma.org>
> >To: trauma-list at trauma.org
> >Subject: tourniquets
> >Date: Thu, 14 Dec 2006 07:47:27 +0000
> >
> >Pret had something with his "compare Baghdad to Baltimore" statement.
> I'll
> >take the liberty to compare Da Nang (circa '69) to Detroit: The homeboys
> in
> >Detroit 1) can't shoot straight (thank God), and 2) (usually) use low
> >velocity weapons (thank God again). Low-velocity GSWs tend to crush
> tissue,
> >and bleeding from an extremity is usually adequately controlled with
> direct
> >pressure.  Wounds produced by high-velocity rounds, however, such as the
> >7.62 x 39 mm (AK-47) produce considerable soft tissue injury and
> sometimes
> >near-amputation of an extremity. Bleeding from these injuries can be
> >difficult to control with direct pressure, and in many situations using a
> >tourniquet may be all that a corpsman can do to keep his Marine from
> >bleeding to death. I doubt that much has changed in terms of GSWs in
> >Bahgdad - the AK-47 is still a favorite killing tool. Likewise, wounds
> >produced by "Bouncing Bettys" (a creative VC modification of the Claymore
> >mine) or the contemporary IEDs are likely t
> >  o prod
> >uce extremity wounds in which hemorrrhage is difficult to control with
> >available hands, thus necessitating a tourniquet. Any young combat medics
> >out there with input?
> >
> >DB
> >--
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-- 
V/R

Forrest Robleto
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

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