Self Defense Medicine Session 6: Tourniquets: Application to Another Person

Now let's talk about how we apply a tourniquet, on an individual. We're going to start with their legs, why? Well, let's say that their leg is injured, so is their arm, well, the leg has a larger artery and vein, so we need to identify that, and then we also need to treat it first. So the first one we do, I've got my Soft-T wide. I'm going to undo the buckle. I'm going to place it underneath this natural curvature of the knee, and I'm going to shimmy it up, re-engage the buckle, and as I tighten it, one thing you've got be sure of when applying this to yourself or your, or someone else, is a couple of things. One, we want to make sure in all fairness, we actually don't get the penis or the testicles caught up between the leg and the tourniquet, okay? Another problem that we found in some of our classes, is, some people carry their car keys, or other little everyday carry tools in their, in their pockets, cell phones and what have you. Depending on how much they got in that pocket, it may start causing some problems or get in the way of the tourniquet. So if you have to, you can get your Benchmade rescue cutter, you simply hook it inside the pocket and start cutting down. I wouldn't recommend using your pocket knife though, because you may end up stabbing him, but take that rescue cutter, slide it down there. You'll open up the, fully open the pocket, all the contents will fall out. It's just a bad habit of taking your, your hand and shoving it down inside a stranger's pockets. You never know what they've got down there. Some sharp objects may stab you and cause injury. So, if we've emptied out the pocket, we've got this tourniquet as high as we possibly can, but never on a joint. We're going to cinch it up as tight as we can, taking up all the slack. Then we're going to turn the windlass, until all the bleeding is either controlled or it stops. You're going to anchor it. Don't forget to put the time on the timestamp there as well. Now that we've addressed the leg, now we're going to, we can move up to the arms. We're going to deploy our Soft-T wide. Now, we're going to have for demonstration purposes, have Rob roll up on his side so we can see this. Now there's two, we've seen some students that'll notice, does it matter which direction, meaning, if I apply it and shimmied it up the arm one direction, or if I swap at 180 and go this direction. Well, it really doesn't matter, but it's more of a personal preference, but I will say this it's a lot easier, if that tail end is facing away from the patient's torso. The reason why is, if it's facing this direction and I've got it up high in that armpit, I can only take up so much because now his chest and his torso is going to be in the way of pulling it. Another thing that we've seen students do, that happens sometimes, is as they're pulling this tight, they'll get this, as they've shimmied up the arm, for example, they may get it twisted up and as they're pulling it, well, they'll get this twist in there, and now they'll either, one of two things will happen. One, the buckle will jam up and now we can't take up any more of the slack, or two, they pull the knot, the, the knot all the way through in that fold and they still can't take up any more slack. So, if that happens, easiest thing to do, is back off a little bit, make sure you've got it straightened, and one way to prevent that too, is to keep tension up against that arm, as you're pulling it up. That way, whenever I pull tension or take up that slack, it's nice and flat and smooth and I don't get, have those problems. Again, I've got it up high on the arm, never on a joint, I turn it until the bleeding is manageable or stopped, anchor it, and of course be sure you put the timestamp on it. So, to recap, if they're injured in the leg and the arm, be sure you address the leg first, then the arm. Those legs, they've got a lot bigger arteries and veins, they can bleed out a lot quicker through those, than they can the arm.