Do you carry a tourniquet when diving?

[pauldw]

TCCC and current PHTLS guidelines are extremely similar IRT tq use.

Yup, some aspects transfer over. But for combat, use TCCC. For ambulance, use PHTLS. For remote medicine in an austere environment, use WEMT.

 

[Bigbella]

Do you carry a tourniquet when diving?​

Only if there's a cascading nose bleed . . .

 

[kinoons]

Yup, some aspects transfer over. But for combat, use TCCC. For ambulance, use PHTLS. For remote medicine in an austere environment, use WEMT.

And all of them agree for major trauma causing severe bleeding to an extremity a TQ is the appropriate first response.

Like I said, if you look at the wound and think you may need a TQ, you likely do. If you want to try some direct pressure while someone get the TQ ready, sure give it a shot, but do not delay a TQ for severe injuries.

This is supported by the NAEMT

https://www.naemt.org/docs/default-source/education-documents/phtls/trauma-resources/phtls-literature-reviews/Prehospital_Tourniquet_Use_–_A_review_of_the_current_literature.pdf?sfvrsn=66d18552_0

Complication rate for TQ placement hovers around 1.5%. Certianly not high enough to worry about.

Some case studies show limb survival well outside 2 hours. Additionally you need to be alive to be worried about your potential for a prosthetic limb. If you wait for the patient to start showing SxS of shock you’ve already lost the battle. There are battlefield cases of patients who died in less than 10 minutes that a TQ would have likely saved.

Injuries requiring a TQ are thankfully pretty rare, but when a TQ is the answer, it’s likely the only answer.

 

[Nemrod]

Do you carry a tourniquet when diving?

Only when I carry a BFK .

N

 

[jadairiii]

I was always of the "anything can work" mentality until recently. I reached out to one of our forum experts on the matter and now have 3 CAT's. They are cheap enough, I keep one in my dry kit bag, one in my car and one on my bike. The bike was part of my decision to buy them, having not too long ago had a pretty serious bike crash. The only first aid I have on my bike, figured after a crash I'll either be out cold (cant do anything anyway) or all street pizza and joint separations (last time) or a "pumper". The first two, no emergency first aid really needed, but alone with a bleed, adding one seemed logical.

 

[GiraffeMarineSalvage]

I can't stress enough the need for proper training (such as a Wilderness-EMT course) to know how to effectively respond in a medical emergency (and statistically thinking preparation for how to prevent/respond to a heart attack / car accident on the way to/from a dive site far more than a shark bite...)
With that said, I also second the sentiment expressed earlier about advances in medical technology in relation to purpose-built tourniquets (such as range at Tourniquets | Chinook Medical Gear, Inc.). ALL modern options avoid unnecessary degree of constriction while spreading the force applied over a wider area than some of the jury rigged options suggested.
Everyone should make their own choices, but for myself I carry a tourniquet spearfishing and/or when diving where tiger sharks (or other more "curious" sharks frequent, and more so with free diving than SCUBA because bubbles to a certain degree differentiate a diver from "normal prey"). I see no point preparing for an "attack" but I see value in preparing for a "bite" under certain circumstances. My personal rationale, based on some logic and a heavy dose of "feels right for me based upon totally subjective risk/reward ratio," is it's worth being prepared for a survivable case of a conflict over fish I shot spearfishing / mistaken identity / "taste test bite." My thinking is under those circumstances my chances of a "bite" increases from close to nothing to something above absolute zero, and IF biten it would most likely be to an extremity and therefore survivable if responded to quickly enough and the right way. None of my above thinking matters if not combined with adequate training, communication (phone/VHF/PLB/etc), AND transport to professional medical care (side note being get DAN insurance before getting a tourniquet though because in the USA seeing the bills for transport and the hospital would kill you from a heart attack if the shark didn't..)

 

[GiraffeMarineSalvage]

(accidental redundant post reading earlier portion of this thread...)

 

[MacDuyver]

After reading about the young boy that was bitten by a shark while snorkeling at Looe Key, I am thankful that a tourniquet and a person that knew how to apply it were close by. They may have saved the boy's life. It would be interesting to know how many of you carry a tourniquet while diving, what brand, and where you stow it? Having one immediately available seems like a good idea to me, could certainly afford one, but am a bit unsure where I would put it on my bp/w along with all of the other emergency equipment I carry on dives. Of course, I realize getting bit by a shark, struck by a prop, or other major bleeding events are not likely, and could be fatal with or without a tourniquet. However, considering all the other safety gear I carry, this might be a game changer in an emergency.

no. (and this is coming from a guy who's day to day involves carrying tourniquets ready to access)

Tourniquets are for large arterial bleeds on the limbs and partial or full amputations. Though large marine predators CAN cause those types of injuries, the frequency of that occurring are tremendously rare. They are not worth the additional snag hazard for the extremely unlikely event of one of those two injuries. I'd keep a couple in the boat, but i would not dive with them.

The rise of tourniquets in prominence has been driven by 20 years of a war where one of the adversary side's primary weapons was explosives, which very often cause limb amputation or massive trauma to the limbs. Even gunshot wounds to the limbs only create a tourniquate worthy wound about half the time.

ALSO - - - tourniquets aren't a Band-aid. you don't just slap one on and call it good. If you carry tourniquets as part of your duty gear, or in a car crash kit in your car, you OWE it to your future patient to learn to use them correctly. There are a lot of really bad guides out there about tourniquets. You must go above the wound (if wearing clothing, current Army practice is to go all the way up to the armpit or groin w the tourniquet), and tighten it until there is absolutely no pulse in the wrist or ankle. Absolutely no pulse. This implies that you learn to reliably find pulses in limbs. Train on yourself (reducing your limb to pulse-less and then loosening the tourniquet immediately afterwards will not cause any limb damage. we do it all the time for training). When you place the tourniquet, pull all of the slack out before you turn the windlass. Make sure there is no skin caught in the buckles. the first thing you'll notice is that it really hurts a lot if you do it right. It must be like this or you'll cause additional problems like compartment syndrome later on down the road, or increased cellular waste which increases the chance they'll lose the limb. At this point, note the time you put it on, and transport the patient immediately to a surgical capable hospital. You will likely need 2 if you're going over neoprene on a leg. Be prepared to put a third on if that person has strong quads. This needs to be practiced to make sure you're doing it right, and will always do it right, because when you try to put one on for real, it's scary as ****.

Wetsuits (and most definitely dry suits) are going to complicate this immensely.

Remember: People don't 'rise to the occasion in a crisis,' they revert to their most reinforced/practiced level of training.

 

[MidOH]

If only there was some strong rubber hose somewhere, on a dive boat.......


Lol.

 

[NW Dive Dawg]

Implementing and understanding and being trained in the application and use of a tourniquet is the key. As long as you are trained and understand that application, then even a "do rag" or shoe lace and a stick can be as effective.....or more.....than an Amazon approved tourniquet. The key is to fully understand and implement the "concept" and purpose of a tourniquet.