Medical Kits And Tourniquets
BY Herschel Smith
3 years, 7 months ago
It has come up in comments and posts, so I thought it would be time to broach this subject. This isn’t intended to be comprehensive or even educated. It’s a platform for you to add, subtract, or give your own opinions or products.
First of all, I found this DoD document detailing a number of different types of tourniquets and their potential failures and advantages.
In this document I found out that the type of tourniquet that I seek, a mechanical tourniquet (see here as well), is found to be superior in practice because of the difficulty of one-handed application and use. The downside is that if a user turns the crank the wrong way he can break the mechanism, although that’s not a very common failure.
John Lovell has addressed the issue of full medical kits here, here and here.
If you have suggestions for med kits or tourniquets, please drop them in the comments and explain why you like them or have them.
On August 30, 2020 at 8:47 pm, TexasMedic said:
I have not been impressed with the MAT tourniquet you linked to. Although it does generate effective pressure, I found the device itself to be bulky and the thumbwheel non-ergonomic, especially in elevated stress conditions. A newer alternative you may find interesting is the m2 ractcheting medical tourniquet. We’ve put that through the paces and found it is impressive at really quickly and easily generating adequate pressure, and is quite easy to apply one-handed.
That said, we carry all CAT tourniquets, and to simplify the advantages of muscle memory, I also carry all CAT tourniquets in my bags, vehicle, home, etc. With minimal training, these are not difficult to apply one-handed. I have seen these used on over a hundred different serious injuries—gunshot wounds, stabbings, amputations, and more—over the past few years with a very high success rate in controlling hemorrhage and a very low failure rate. The most common failure points were either patient condition—very obese being the most common one—or operator error—failing to tighten adequately, intentionally or accidentally loosening.
As regards med kits, there are a lot of exceptional options out there. On a general level, you are looking for options to treat the readily reversible causes of traumatic death: exsanguinating hemorrhage, airway collapse, and breathing problems caused by chest trauma. Serious extremity bleeding is best controlled using a tourniquet, but if it’s too high for a tourniquet or located in the groin, hips, or shoulder, then packing the wound with gauze is the best bet, and hemostatic gauze such as QuikClot is a useful idea. Serious trauma to the head, chest, or abdomen are not something generally treatable from an aid bag or med kit.
An important distinction should be made between a full-fledged first aid bag and a med kit. The med kit should be small enough to be on your person or closely at hand, and is intended to treat immediate life-threatening problems. A first aid bag is also beneficial, but is also typically larger and more focused on both longer-term care and less-severe problems. Your med kit should let you stop significant bleeding from just getting shot, while the first aid kit will let you clean out and bandage large scrapes and cuts.
My med kits generally carry a tourniquet, some form of Israeli bandage, quikclot combat gauze, an NPA with packet of KY, a chest decompression needle, gloves, z-fold compressed sterile gauze, and chest seals. All of these kits are quite small. My bag also has a small first-aid kit, similar to the ITS Tactical Boo-Boo Kit. My in-vehicle and at-home first aid kits are quite a bit larger. For these, I would recommend Adventure Medical Kit’s Mountain series.
With all of this, training is essential. For general first aid, a CPR and First Aid course is a great idea; one put on with national sponsorship from AHA, Red Cross, or ECSI increases your chances of finding quality. For trauma care, a Stop the Bleed class will get you a great start, and these have a nationally standardized curriculum. Beyond this, obtaining an EMT certification is usually not very hard, time-consuming, or expensive, and does provide a much more substantial foundation in emergency medical care.
Finally, my credentials (I do know what I’m talking about): in EMS for 15 years, a paramedic for 12. I’ve been teaching emergency medical care at all levels for over a decade, and I currently run an accredited paramedic program. I am also a senior administrator for a nationally known ambulance system that has worked closely with military physicians and law enforcement tactical medics.
On August 30, 2020 at 9:02 pm, Herschel Smith said:
Please give link to your recommended tourniquet.
On August 30, 2020 at 9:31 pm, Ratus said:
I’d avoid that tourniquet for many reasons.
The first is that it is unusual. The TQs that you are carrying may need to be applied to you by someone else and if they have to try and figure out how to use it for the first time when they are trying to save your life is a bad idea.
My second point is that of bulkiness compared to the other common TQs like the CAT or SOFFT-W. Both of them can be folded to store compact and still be ready to deploy quickly.
The third is the price. I know that price shouldn’t be your main reason for choosing life saving equipment, but at over $50 shipped for one. It’s a little bit much for what you are getting compared to the $30+/- of the others.
You will want to have at least two on you, one in your ifak and the other readily available in a pouch or other quick access storage. So getting two gen 7 CAT TQs from North American Rescue for $60 shipped is a better use of anyone’s limited funds.
Also, here’s a good video by PrepMedic on folding the CAT TQ for quick one handed use. youtu.be/CSECJQPJmLw
On August 30, 2020 at 9:34 pm, Ratus said:
And here’s one for the SOFTT-W by PrepMedic. youtu.be/kaVdfPFHZsQ
On August 30, 2020 at 10:04 pm, Scott Smith said:
Gentlemen above hit the nail on the head, CAT and Swat-t are the best in my opinion. There are lots of CAT types on the market, North American Rescue is the original and one of the best, Recon Medical is another good one, slightly less expensive, all the rest are cheap chinese crap, and this is one case where your life truly depends on it, DON’T BUY THEM! stick with the two i mentioned. I carry those (two in a kit in each vehicle, and one on me at all times) the Swat-t is like a big stretchy band, like the stuff used in physical therapy. It’s not as easy to use as the CAT, but it’s advantage is that it’s one long piece. Not only is it in my personal kits, but in those on our department, and for the same reason. If God forbid you have to use it on children, one can be cut into pieces for use on multiple kids / small adults. The combination of the two seems ideal to me, as well as quick clot gauze for packing wounds, Israeli bandages, and packages of celox (the clotting agent in quick clot gauze, sprinkle on a wound and then use regular bandages ) is the basis for my kits, along with chest decompression needles (two, one for each side) and chest seals.
On August 30, 2020 at 10:11 pm, Herschel Smith said:
@Scott,
Links please. All you guys supply links or it’s of no use. Haven’t the time to make the search. Help me out this way please.
On August 30, 2020 at 10:21 pm, Ratus said:
Don’t buy CAT tourniquets on Amazon!
You will likely get a Chinese fake copy.
North American Rescue is the authorized supplier.
They also have the other items that you will want to have in your ifak, and orders over $50, which is very easy to reach, are shipped UPS for free.
As TexasMedic suggested a compression bandage, z-fold compressed gauze, and some chest seals are relatively inexpensive.
With the hemostatic gauze being somewhat expensive at around $45-50 each. The normal gauze is almost as effective. And again I have a video by PrepMedic about this. youtu.be/p41qvnFn–c
Here’s a link to a minimal kit at NAR with a CAT TQ, 4″ compression bandage, z-fold compressed wound packing gauze, and twin pack of HyFin chest seals.
narescue.com/community-preparedness-products/individual-throw-kit.html
Two of those would be the be enough for a well equipped IFAK. I’d suggest you add some more compressed gauze, it’s only around $3-4 each for 3″ x 4-5yards in a tiny package.
On August 30, 2020 at 10:29 pm, Ratus said:
The Swat-t is not a TCCC approved tourniquet.
I’d stay away from any of the non-approved tourniquets.
On August 30, 2020 at 10:37 pm, Ratus said:
Also, chest decompression needles and NPAs (nasopharyngeal airway) are items that require a prescription/credentials to order from most suppliers in the US.
There is a good reason for the chest decompression needles because with out training you can cause serious issues.
The NPAs are another thing, most people can administer one correctly without formal training. (If anyone wants to disagree, please do.)
On August 30, 2020 at 11:01 pm, Ozark Redneck said:
This is what we use, and I believe this is what they are discussing:
https://www.narescue.com/combat-application-tourniquet-c-a-t.html
On August 31, 2020 at 7:43 am, Wes said:
@Herschel RE links:
Gen7 CAT:
https://medicalgearoutfitters.com/collections/tourniquets-holders/products/gen-7-combat-application-tourniquet-c-a-t
Gen4 SOF-T:
https://medicalgearoutfitters.com/collections/tourniquets-holders/products/sof-tourniquet-gen-4
Both xlnt; both make the TCCC folks happy. Have handled both; and both also have a config that they are useable for children or skinny-limbed oldsters. Have purchased from outfit at links, but no personal connection other than as customer. The owner also has a variety of teaching videos on the youtube under Skinny Medic.
Happy trails.
On August 31, 2020 at 3:00 pm, Sanders said:
This is arriving today:
https://www.amazon.com/gp/product/B07CG9HFSF/ref=ppx_yo_dt_b_asin_title_o01_s01?ie=UTF8&psc=1
On August 31, 2020 at 7:33 pm, Nosmo said:
North American Rescue (https://www.narescue.com/, tel:1-888-689-6277 or tel:1-864-675-9800) has good on-body kits:
The “ROO M-FAK Kit” (https://www.narescue.com/roo-m-fak-kit.html, Item # 80-1049) is $79.99 and comes with:
1 x C-A-T® (Combat Application Tourniquet®) Black
1 x 4 in. Flat ETD™ (trauma dressing)
1 x S-rolled Gauze (4.5 in. x 4.1 yd)
1 x HyFin® Vent Compact Chest Seal, Twin Pack
1 x pair Bear Claw® Nitrile Trauma Gloves, large
It’s L 7 in. x W 3.75 in. x D 4 in., 13 ounces, has twin snap-straps for MOLLE or your belt. The CAT is in its own compartment on the exterior of the larger pouch, and there’s – barely – enough room inside the larger pouch to very carefully squeeze in a second CAT.
Adding the hemostatic gauze moves the price to $124.99 (Item # 85-1053). There’s an Advanced option for $140.99 that includes a Nasopharyngeal Airway and Needle Decompression Kit.
The ROO M-FAK is a small kit, a little bulky but suitable for on-body (I belt-carry one daily, have a backup in the vehicle, and one on the plate carrier MOLLE).They have larger kits in almost any size you might want (https://www.narescue.com/catalogsearch/result/index/products/1/?p=1&q=IFAK+kits).
There are other firms who make equally good kits, I happen to know about NAR because I’ve bought equipment and supplies from them a number of times.
Ratus (above) makes a very good point: There may be a Whizz-Bang or Sooper-Dooper tourniquet from Company X, but if you haven’t trained on it, practiced with it, and MOST important, the people with you haven’t either, you’re may bleed to death while they try to figure it out.
Joe and Jane Citizen have likely never seen any tourniquet before, much less been trained how to put one on someone, but the CAT is simple enough verbal instructions can probably get them through it. It’s also the most common tourniquet in use, with the SOFTT-T a close second.
There may be a different design, that
may be faster to install, perhaps more effective to use, but unless the user knows how to properly install and use it, it’s not much good. Remember, while people trying to help will probably find the med pouch – it should have the standard medical cross insignia on it – you may not be conscious and able to provide then with instructions. My former agency trained the 911 operators how to instruct someone to use a CAT tourniquet so they were a resource.
On August 31, 2020 at 8:06 pm, Scott said:
Ratus,
Sorry, in reference to the chest decompression, I should have mentioned that I’m a medic. As for the Swat-t not being TCCC approved, that is true, though our local medical director has them in our protocols, and the ability to cut them to use on multiple patients / smaller kids makes them a good second line for those that a CAT won’t fit. For adults, the CAT is always my go to.
https://reconmedical.com/
On August 31, 2020 at 8:16 pm, Peter B said:
CAT is the standard for a good reason. But if you have any physical limitations, you may find that they are hard to apply to yourself, on some parts of your body at any rate, in some situations. If that may apply to you, get a CAT or CAT trainer and try it. For me, the problemis when I’m on the ground applying to the opposite thigh whether I’m using my right or left hand. I find the RATS to work better for that application.
On August 31, 2020 at 8:35 pm, Stephen Arthur said:
I highly recommend the TX tourniquets from revmedx.com
Puts all other TQ’s to shame. Only slightly more expensive than the CAT
and made of top quality materials. Far faster to apply too. American made.
TX is second to none