'Cult’ of tourniquets causing thousands of unnecessary amputations and deaths in Ukraine, say surgeons

RockAndSage

RockAndSage

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Posting for general consideration, especially for those who may find themselves in remote places beyond the 2-hour window of receiving hospital care. The pendulum needs to swing back a bit towards judgement and more thorough, nuanced training on tourniquets and bleed control.

And seriously - if you carry a TQ, have actual TQ training, or especially if you provide emergency medical training, please read thoroughly and consider before commenting.



 
Fatcamp said:
but man some of the stuff that gets applied unnecessarily makes my head spin
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Same. I liked that the US surgeon in the article laid out the three key times to actually use one, and not to just slap one on any given bleed. The renal failures associated with improper use was news to me though, hadn't been aware of that.
 
RyanT26 said:
Luckily when I am hunting I don’t find myself pinned down by artillery and drones for days.

TQ are easy to carry, use, should be in your kit. It’s not rocket surgery.
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Do you ever find yourself hunting while out of cell service, 2 hours from a hospital?

And I suppose the air medical assets in your community are not subject to unexpected weather restrictions, mechanical troubles, and are always on call for you and no other medical emergencies while you're hunting?

RyanT26 said:
TQ are easy to carry, use, should be in your kit. It’s not rocket surgery.
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Did you even read the article before commenting?

Ease of carry, use, and 'it's not rocket surgery' are exactly why 75% of TQ usage is deemed improper, and why tens of thousands of dudes have lost limbs unnecessarily over there.
 
Good info. We had an unfortunate range accident a while back where someone dropped his pistol, attempted to grab it, and shot himself through his calf and foot. We put a tourniquet in place but never tightened down. just had it in place in case we weren’t able to manage the bleeding with pressure alone. It ended up not being necessary and the ambulance got there in about 15 minutes. Ended up being a pretty minor injury with nothing major hit.
 
Interesting read for sure and definitely a sad situation having so many unnecessary amputations.

I do wonder how they determined which amputations were caused by inappropriate use - did they investigate the limb to determine if major arteries were severed? It would just be interesting to know.

I perform ambulatory surgery (Mohs surgery) and even small arteries can produce quite a bit of bleeding that won't stop with pressure alone - usually employing electrocautery or ligation is required to obtain hemostasis. That's with a patient resting comfortably on a procedure table. I would imagine the battlefield would be even more intense, so I can understand why they are being applied too often. Hopefully the new training will be effective.
 
@RockAndSage
Yes I read it. I am sure TQ have cost some guys limbs over there, among others things.

Over 2 hours does not mean the limb is unsaveable. Without getting into the incompetence/lack of training of the Ukraine soldiers or political, I am sure they are given a crash course on TQ and sent the the front. Telling them to TQ everything is much simpler and quicker than teaching proper wound packing and bandaging, basic assessment, and triage.
Realistically, if you get an arterial bleed in the backcountry or even hunting the back 40 you better have your shit together and know where your kit is otherwise it really won’t matter. It may not even be due to blood loss. People go into shock or sometimes just totally freeze up or panic. I would much rather have one on a little early and give myself the opportunity to get my bearings and reassess the injury then too late.

If I had a bleed that I was not able to control by packing it with gauze, bandaging it, pressure, or even using quick clot, which I don’t believe is recommended to use anymore unless they have changed that recommendation again. I would not hesitate to put a tourniquet on it to by some time, especially if I was by myself or even with hunting partner.
 
Didn’t read the whole article but enough to get the point.

I hunt solo often and let me put it this way, I think I’d rather be alive and missing a limb than dead because I lost consciousness trying to apply pressure long enough to stop a bad bleed.

That being said, maybe I should add an Israeli bandage/pressure bandage to the IFAK.

With many things in life, there is a balance.
 
Back when I was working EMS, at least once a month some dip shit would put a tourniquet on his buddy or himself.
One guy had a bath towel strapped down with 2 belts. No blood anywhere. He screamed like a chick at a nickel back concert when I took it off. “I’m gonna die, your gonna kill me!! “
I’m like dude shut up. I put 2 bandaids on your half inch cut.
 
The situation in Ukraine certainly appears to be a "different" kind of war than the US has been publicly & directly involved in the last few decades.

The lack of rapid evacuation/ treatment of wounded seems to be the mitigating factor with reference to the TQ in the article.

In the US, for hunters and recreationists, while I'm sure there are instances where it would be impossible to have rescue/trained medical care within 12 - 24 hours, it would be interesting to see what the stats would be for time to medical care in SAR situations.

IIRC, often in TQ training, the practice of loosening the TQ at intervals is often mentioned in conjunction with being administered by a trained professional. Perhaps that will become part of the training protocol for laymen in the future?
 
When in the back country and you have to apply a TQ to your hunting partner, before leaving him unconscious to go after that monster muley, make sure to put a "T" on his fore head with mud or blood so the rescue party will know about the TQ. See I was properly trained in the army.
 
Rokbar said:
When in the back country and you have to apply a TQ to your hunting partner, before leaving him unconscious to go after that monster muley, make sure to put a "T" on his fore head with mud or blood so the rescue party will know about the TQ. See I was properly trained in the army.
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A “T” with the time it was administered.


____________________
“Keep on keepin’ on…”
 
I have an acquaintance who's life was saved by his partner applying a TQ in the backcountry. He went for a ride in an avalanche, broke his femur and was bleeding out. Everything kind of worked out perfectly as his partner had a InReach, the SAR helicopter happened to be in the air in the general area doing some training, the injured party ended up in an open area where the helicopter could get an EMT on the ground and have the injured guy loaded in a matter of minutes. I believe he was in the ER within an hour of the injury.

I don't buy into the "if you can't address the wound with duct tape and TP, you're dead anyway" mindset.
 
insanelupus said:
The situation in Ukraine certainly appears to be a "different" kind of war than the US has been publicly & directly involved in the last few decades.

The lack of rapid evacuation/ treatment of wounded seems to be the mitigating factor with reference to the TQ in the article.

In the US, for hunters and recreationists, while I'm sure there are instances where it would be impossible to have rescue/trained medical care within 12 - 24 hours, it would be interesting to see what the stats would be for time to medical care in SAR situations.
Click to expand...

This is really important to point out. Tourniquets became popular in the War on Terror, when we could generally evac someone whenever we needed to. If a TQ wasn’t necessary, you were probably going to be at a Role I within 2 hours, and it could get reassessed there.

In Ukraine, drones are so bad that in some cases dudes are having to wait on evac until their limbs are already turning black and gangrenous.
 
There has only been one time wear I was convinced I was going to need a turniquet while hunting. I ended up not needing it at all. But I am thoroughly trained and experienced and know how and when to use one.

If you have experience dealing with a dynamic, high-stress situation, you learn how to access things rationally rather than panic and make more mistakes.

The great majority of people do not have that experience and so they end up making rash decisions.

Sent from my SM-S918U using Tapatalk
 
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