Talk About Tourniquets

Recently as part of a SWAT class I was attending, I had the chance to get a refresher course on tourniquets. I know, I know. It’s not as sexy as SBR’s in exotic calibers with suppressors and giggle switches. It’s not as interesting as the History of the Registered Magnum. Yet its importance cannot be stressed enough. Self-defense shooting and training are all about survival, and tourniquets are exactly that — survival. 

They are nothing new. The application of combat tourniquets has been documented to go back as far as WWI. Simply put, if you have an arterial bleed in an extremity, a properly applied tourniquet helps to stop the bleeding and buys time for treatment. It doesn’t have to be from a gunfight either. It can be from a car wreck, an industrial accident, or just plain-jane bad luck.

A good friend of mine, Collin Hastey, was a patrol officer in a nearby town when a call came out about a man bleeding on the front of a residence. When Collin arrived, he applied a tourniquet to the victim’s arm which had been cut by sticking it through a plate-glass window. No doubt Collin saved a life that day.

I have personally been on multiple calls of a similar nature: a woman through a plate glass window with a severed brachial artery, a couple of vehicle accidents with partial or complete amputations, stabbings, suicide calls, etc. One of the messiest death investigations I ever worked was a death call where, again, a plate glass window cut a major artery and the victim bled out, probably in minutes. It was definitely exacerbated by alcohol. Alcohol and plate glass has actually been something I’ve seen WAY too much of.

Each of these calls would have definitely been helped if a tourniquet had been applied properly and in time. Very few of them were calls where they were applied or even attempted. Many of them resulted in, in my humble opinion, the avoidable death of the victim. Yet the general public, outside of military or former military, almost never even thinks about tourniquets, even in the extreme cases where they are faced with a life-saving OPPORTUNITY.

How do we fix this? SIMPLE. We follow the basic cycle of Equip, train, modify, repeat and expand. Then we repeat the cycle in expanding circles of self, family, work, social, and community. Here are some examples for each step of the cycle.

Equip yourself

Start by getting one or two tourniquets. There are plenty of versions out there but the one I use, because it’s the one most trained on is the CAT tourniquet. Remember, your tourniquet may be used by someone other than yourself. It’s probably a good idea to have the one that the MOST people will know how to use. Think of it as carrying mags that your partner can use in their gun. Most of the tourniquets on the market work similarly but I don’t want anyone applying it to me to have to figure it out on the spot, and I also want to be able to explain how to apply a tourniquet to someone else without looking at it.

Tourniquets: CAT and RATS
The CAT tourniquet and the RATS tourniquet—both viable options, the RATS is definitely easier and
smaller to pack, but the CAT is more widely trained on and used.

Now there are fake and counterfeit CAT tourniquets out there so use a reliable vendor and don’t cheap out on them. It may seem like a good idea to save a buck or two here and there but when you need this thing, it’s life or death and the fake ones DO FAIL. Don’t risk it.

Train yourself.

Get your tourniquet out, clear a space in the living room in front of the TV and play this video.

Practice applying the tourniquet to yourself. Don’t chicken out and not tighten it down. REALLY DO IT. Over and over. See how fast you can apply it one-handed to yourself. Legs and arms. The worst thing that happens is it hurts (a properly applied tourniquet does hurt) and you might get a bruise or two. Now do it with your eyes closed. YES. I’m serious. In SWAT class in very little time the instructor, Smitty, had us all applying them to each other in the dark in under 30 seconds. We literally had 20-second drills in the dark. If we can do it, anyone can do it.

Modify

Your equipment and your practices. Where is the closest tourniquet to you right now? Do you have one in the car? Do you have one in every car? Do you have TWO in each spot? Where we encounter one victim, we are highly likely to encounter another. Are they unwrapped and prepped? Smitty and the SWAT Doc both made sure every student knew that plastic wrapping doesn’t help. Get it out of the wrapper and get it ready to use. You can unwrap it now, or you can waste time and blood unwrapping it when you really need it.

CAT Tourniquets, one in plastic packaging
CAT tourniquets come wrapped in plastic, and if you get one in a kit, TAKE THAT S”*# OFF. Don’t waste time and effort when you really need it.

The modifying stage is all about making a change that makes you better. NOT PERFECT. PERFECT is too big a bite. Just take a simple step such as adding another tourniquet or two. Make sure you have a pair of tourniquets in each go-bag or in each medkit in the cars. Add a tourniquet holder to your gunbelt. Make sure you have a kit INSIDE your house, each of your vehicles, and if you have a personal space at work, THERE. If there is a fire extinguisher there or there should be, a stop the bleed kit and or med kit containing a tourniquet should be close by and as well marked.

four tourniquets
How many tourniquets are enough? How many limbs do you have? Where all are you going to keep them? Kinda like magazines…maybe you will have enough when you need them.

Repeat and Expand

Simply repeat the steps and expand on them. Get your significant other to go through steps 1-3. If you have kids who can handle learning about this, run them through the training. Show them where you keep your tourniquets. Make sure your wife or husband (I really hope we have as many women as possible reading this) has a pair of tourniquets and maybe a Stop the Bleed kit in their car. Make sure you have one in the house.

I bugged my buddy, Paul, who is a shooter and an all-around good guy, to read the first draft of this article. After which Paul and I had a quick session where I explained the use of a CAT tourniquet. I demoed it for him and set him up to let him practice it ONE time. After that, I timed him on putting it on himself from go to the stop of blood flow to his hand. He put it on one-handed in 30 seconds literally the second time he tried it.

self-applied CAT tourniquet
Make sure you put the tourniquet high on the limb and keep the windlass to the outside. In just five minutes of discussion, my buddy Paul quickly learned to use a CAT tourniquet properly and was able to self-apply it in thirty seconds.
CAT tourniquet secured on the arm
When placing a CAT on the arm, Smitty and SWAT Doc taught us to finish the application off by wrapping the tail around the windlass and back to the body before securing the time strip across the gate. Trust me. It makes more sense with a tourniquet in hand.

I didn’t teach him how to use the RATS. I set the bag before him and told him he just lost his left hand and said go. Opening the package was a hurdle quickly followed by figuring it out. He was about a minute thirty or so in when I told him there were instructions on the label he just tore apart with his teeth. Now REST ASSURED. I’m not bagging on or saying ANYTHING bad about the RATS. It is a QUALITY piece of gear and it WORKS. What I was proving to myself and to my friend is exactly how bad trying to figure it out will be when you are bleeding to death.

Paul works as in industrial welding and construction. He instantly saw the need to add tourniquets to his everyday gear as well as his go bags. I wasn’t stingy and made sure my buddy left with a brand-new CAT tourniquet to add to his gear. He immediately tore the wrapper off and loaded it properly before stowing it in his EDC pack. I was never so proud.

RATS Tourinquet
CAT tourniquets also come in bright orange.

Repeat the training for yourself as a refresher. Maybe take more time with it this time. Maybe find yourself a friendly and capable EMT or doc and have them run you through. Trust me, as good as a video is, it doesn’t touch what a good doc or medic can teach you. Heck maybe find yourself a local class and go get some training in more than just tourniquets.

Now that we have covered the basics, let’s talk about other ways to Expand. Go to your local gun store and ask if they carry tourniquets. WHY NOT? Do we sell hole punches but not hole patches? I can buy ammo locally, but I have to go online to get a tourniquet? That just doesn’t make sense. There should be an endcap at every gun store with tourniquets and medkits. If you want your local retailer to provide a product all it takes is for a few people to ask for it. Go and ASK. Many cops and firefighters and even just good Samaritans will likely make an impulse buy if it’s just out there where they see it.

CAT tourniquets also come in bright orange.
CAT tourniquets also come in bright orange.

I checked today and there are absolutely ZERO places in my town or even within 40 miles that sell tourniquets. Not one gun store sells them. The only place you can get them is at a medical supply store. So, me being the man of action I pretend to be, I went to my local gun store today and made the suggestion to the store owner who seemed receptive. Zero hassle. He just said yeah that seems like a good idea and asked for the contact info to stock the model we use.

Next, do the local first responders have tourniquets and training? You might be surprised. Small towns, and counties may not have them. They may have them but not have trained. Newer officers may have been overlooked. Make sure your local officials dedicate time and money towards it every year. CPR, first aid, and Stop the Bleed should be prioritized not just on the training roster but in the budget.

Bleeding Control Kit, Georgia Trauma Commission
Georgia’s Trauma Commission provides free training and bleeding control kits to law enforcement,
first responders, schools and churches.

What about your church, your school, your job or your business? WE need to NORMALIZE emergency medical training. CPR, first aid, stop the bleed, etc. It should be a normal thing not the exception, that a business, or a school staff, or a church congregation takes a class on a lifesaving device.

Does your local fire department have them? Full time is likely but what about the volunteer firefighters? There are lots of programs that provide the training and provide stop the bleed kits for first responders for free. Georgia has a program that helps provide kits and training to first responders and also to schools, and churches free of charge. These kits include tourniquets.

medical kit with a CAT tourniquet
The kits contain a CAT tourniquet along with other medical supplies to do exactly that, STOP THE
BLEED.

While I’m writing this, I’m going over in my head each of the calls I’ve been on where I should have had or someone I worked with, should have had a tourniquet and the training to use it. I’m not getting down on anyone but myself. I should do better. I need to help normalize tourniquets and medical training in my circles. Since I had the medical class in SWAT training, I’ve shared training and equipment with one officer who is fresh out of the academy and eager to learn. As the new year rolls in
I’m going to help push for refresher training for my agency, I’m going to work on getting my family stop the bleed kits and I’m working on expanding my training and equipment personally. WE should never miss an opportunity to save a life again.

I hope you never have to use it but more importantly, I hope you never miss the opportunity.

medical kits
Left to right- My GA Stop the Bleed kit, a military surplus KIT, a bigger kit I have had for years, a very thorough and well put together My Medic kit, and an ankle medical kit. I have CAT tourniquets in each of these and on my body armor. The My Medic Kit comes with RATS tourniquets which I kept and added four CAT tourniquets to for good measure.

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