Do you carry a tourniquet when diving?

[Zach The Diver]

…again…training. A qualified first aid course for sure. Perhaps some dedicated DMs looking to learn from your certification agency.

Agreed

 

[MacDuyver]

I specifically noted they can be used to absorb blood, similar to gauze pads externally.

in the case of more than just a scrape or cut direct pressure, hemostatic agents, pressure points, or possibly a tourniquet, is needed to actually stop bleeding.

The goal with hemcon though is to keep the blood in the body.

I’d argue compartment syndrome should at least be taught in layman’s terms. It’s easy to see how a relatively untrained person may stack TQs on a limb with space in-between them to “be safe” or otherwise stop a bleed one TQ may not be doing enough for.

the beat way to avoid compartment syndrome is to get full tourniquation and render the limb completely pulseless. Compartment syndrome is generally caused when the tourniquet is 75-80% tight and still has a faint pulse but the person rendering aid stops turning because the bleeding looks like it stopped, instead of checking for pulse in the distal portion of the wounded limb and ensuring there’s none. That takes a bit of practice though.

That said, as miserable as compartment syndrome is, I’d rather have that than bleed out from a prop strike to my arm or leg

 

[Johnoly]

..... instead of checking for pulse in the distal portion of the wounded limb and ensuring there’s none......

That's great information.
It's too bad it's not taught or mentioned more on SB/in class/rescue courses/others. In the urgency of the event, we become so 'tunnel visioned' on the task only - stop the blood loss. Knowing all the hows and wheres to check for distal pulse location (not just the wrist) would be a great part of blood loss training.

 

[Scott G. Bonser]

That's great information.
It's too bad it's not taught or mentioned more on SB/in class/rescue courses/others. In the urgency of the event, we become so 'tunnel visioned' on the task only - stop the blood loss. Knowing all the hows and wheres to check for distal pulse location (not just the wrist) would be a great part of blood loss training.

Again, seek out a really good Divemaster course from a reputable agency. Although I am no longer considered an active DM ( …on my thwarted way to becoming an instructor…) PADI certified me after extensive training and a number of O/W ‘class assisting events’ back in 84. I had to have a sanctioned American Red Cross First aid ( tourniquets and direct/indirect pressure taught there as well as others ) CPR, and Lifeguard courses which you HAD to pass and keep up-to-date. I really learned a great deal and can still perform many lifesaving maneuvers. Another thing is…Take control of the situation, especially if you aren’t squeamish. Put others to work especially in the most dire of cases. Y’know where I am coming from, I believe. Again you may just be in a ‘me-myself-&-I’ situation where minutes and even seconds count….

 

[Zach The Diver]

The goal with hemcon though is to keep the blood in the body.

the beat way to avoid compartment syndrome is to get full tourniquation and render the limb completely pulseless. Compartment syndrome is generally caused when the tourniquet is 75-80% tight and still has a faint pulse but the person rendering aid stops turning because the bleeding looks like it stopped, instead of checking for pulse in the distal portion of the wounded limb and ensuring there’s none. That takes a bit of practice though.

That said, as miserable as compartment syndrome is, I’d rather have that than bleed out from a prop strike to my arm or leg

Very good points. Not an uncommon occurrence when trying to apply a tourniquet to the femoral artery or to a… more tissue-dense person.

Issue is one that you already alluded to- distal pulses. Not very easy for a layperson to go fishing for a posterior tibial pulse in an already charged environment.

Also a distal pulse isn’t always palpable, especially in the case of comorbidities such as severe fractures or other complex injuries.

Absolutely agree with you and such things should be incorporated into training, but I’d also argue that simply training people to simply NOT be afraid to apply a tourniquet properly and to practice routinely is just as important. Just remember that it isn’t going to feel amazing!

 

[MacDuyver]

I’m all about tourniquets too and wish civilian medical courses were less gunshy about them. They’ve saved thousands of lives in the military over the last 20+ years. I’ve seen them go quite literally from a last resort to a first resort for major bleeding. They take a bit of training but damn they work. If you spend a couple hours with a professional learning the nuance to them.

 

[Scott G. Bonser]

I’m all about tourniquets too and wish civilian medical courses were less gunshy about them. They’ve saved thousands of lives in the military over the last 20+ years. I’ve seen them go quite literally from a last resort to a first resort for major bleeding. They take a bit of training but damn they work. If you spend a couple hours with a professional learning the nuance to them.

To all who read these posts… it’s a ‘mindset’. Being able to handle the emergency is priority one. Even the least experienced and marginally equipped tourniquet technique CAN SAVE A LIFE. Don’t ignore the problem. It won’t go away but your patient may if not performed in a timely manner…. Goes with any lifesaving maneuver as well. Bear in mind you CAN lose a patient, however you have to try!!! I really enjoyed reading ALL of the posts and replies. It shows we as divers are safety and rescue minded. Touche’.

 

[Johnoly]

, however you have to try!!!

I'm not a medical person. Might someone have/create a diagram here where the 'Distal pulse locations' would be that are not usually covered up by gear or thermal stuff? I'm guessing a prop blade could hit anywhere from head to toes so the whole body is a target.

 

[MacDuyver]

I'm not a medical person. Might someone have/create a diagram here where the 'Distal pulse locations' would be that are not usually covered up by gear or thermal stuff? I'm guessing a prop blade could hit anywhere from head to toes so the whole body is a target.

Distal means the far end, so wrist or foot/ankle.

The radial is your classic pulse in the wrist just behind the thumb. Posterior tibial is in the little pocket on the inside of your ankle, but I usually have an easier time finding the dorsalis pedis which is in front of your ankle on top of your foot. It takes a bit of practice to be able to easily find those on people and it can be a little tricky finding them on yourself. They can feel pretty faint However it’s the most surefire way.


“Exposed” is where the tricky part comes in. And requires a bit of training to work your sequence out. A wetsuit or drysuit sleeve is going to require rapid removal because not only is it going to block your ability to feel a pulse, but it’s a lot of squishy material that’s going to reduce the tourniquet’s effectiveness. A trilobite works in theory but actual trauma shears work more betterer. They can cut Pennie’s in half and will make quick work of a wetsuit. If you’re building a first aid kit include one or two sets of them. You don’t need the badass North American Rescue ones, the inexpensive ones will work fine.

 

[Scott G. Bonser]

I'm not a medical person. Might someone have/create a diagram here where the 'Distal pulse locations' would be that are not usually covered up by gear or thermal stuff? I'm guessing a prop blade could hit anywhere from head to toes so the whole body is a target.

Sometimes a compound series of wounds are a complex problem. You may need to work w/what is available to save a life. These kind of injuries are where seconds count.