Do you carry a tourniquet when diving?

[kinoons]

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


Lol.

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.

I strongly disagree with both of the above. The answer for extremity arterial bleeding is a purpose built tourniquet.

Rubber hose? No thanks. Shoe lace or dew rag? No thanks. Prior research and experience demonstrates that improvised tourniquets are less effective and potentially more damage.

Bleeding Control Basic Training Among Laypeople Applying Different Tourniquet Types

This crossover randomized clinical trial assesses whether participants completing the American College of Surgeons Bleeding Control Basic training with Combat Application Tourniquets can effectively apply bleeding control principles using other tourniquet types.

jamanetwork.com

https://www.stopdebloedingredeenleven.nl/app/uploads/2020/02/10.1007_s00068-019-01202-5-Cornelissen-EJTES-2019-2.pdf

 

[MacDuyver]

I’ll second the Do-rag and shoelaces are awful tourniquet alternatives. They cause tons of tissue damage and usually don’t stop the bleeding. The only alternative I would consider would either be a rats, tourniquet or a 2-3ft piece of surgical tubing. Both need to be wrapped 4 to 5 times around the Lim in order to exert enough pressure to squeeze off the artery. Also if you apply them correctly and tightly and put the wraps right up against each other additional tissue damage is minimal.

To the point of understanding, the principles in order to improvise, I would argue that if you have a spear gun, the best alternative for a tourniquet would be to use the bands from the spear gun. That’s still pretty janky and is VERY technique dependent which means you need to practice it a bit before you count on it as a life saving measure

All said and done, even shark bites don’t typically produce wounds you’d need a tourniquet to control the bleeding on.

 

[GiraffeMarineSalvage]

Also something to think about, a purpose built tourniquet properly used prior to reaching definitive medical care may be a life saver for a boat propeller strike in addition to the much lower risk statistical risk of a shark bite...

 

[happy-diver]

Yeah, the last guy I did didn't give a rats arse, when unapproved uncoursed or qualified or practiced
I rose to the occasion with an electrical cord, him having splashed a couple of litres of blood around
close to death although he was a bit embarrassed his attempt was unsuccessful, he thanked me later

 

[Thunder Struck]

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


Lol.

Or thick nylon webbing... Wonder how well a cam band would cam over for shutting off blood flow?

Before we had the fancy and readily available tourniquets I had the unfortunate experience of having to use a field improvised tourniquet. Long story short, while in Iraq a car tried to bust through a control point. Driver caught a round in the left bicep from a 5.56 that went through the car door first. Only thing holding his lower arm to his shoulder was the skin on either side of his bicep. Muscle was shredded and humerus completely shattered. Cut a length of cloth from the dude's pants, then wrapped it high up against his shoulder with an overhand knot, used a one of the 4" long bolts that were rolling around inside of our Humvee as the handle, another overhand knot and proceeded to crank. Blood flow stopped almost like turning off a faucet.

Funny part was when the medic got there from the medivac he went to grab a pulse from dude's wrist. Medic had a puzzled look on his face trying to see how this guy was still semi-conscious with no pulse. Made a quick mention he might want to try to get a pulse from the arm without the tourniquet.

At any rate, as cheap and available as the modern tourniquets are, there's no reason not to have one in most any decent first aid kit. Direct pressure is nice if you have someone to assist with what is going on. But if it's just you and the patient and you have other things to tend to like needing to move the patient a distance, you'll need something more. Anyway, just my thoughts having been through the experience.

 

[MacDuyver]

Or thick nylon webbing... Wonder how well a cam band would cam over for shutting off blood flow?

It works stunningly poorly. It's too rigid to work as a tourniquet. We've tried it out. You'll get better hemmhorage control kneeling into the patient's groin or armpit and tampenading off the artery with your knee.

Caveat: It works very well for a pressure dressing (likely more appropriate of a treatment for even a shark bite). You'd want to put the bulky dressing onto the wound, cinch the band snug and then cam it to create a pressure dressing. This style of dressing though doesn't even begin to deliver enough pressure to close off an artery.

 

[OMyMyOHellYes]

Is that because use of a tourniquet substantially increases the likelihood of needing to amputate?

People that bleed out are dead and don't require amputation.

I'm assuming that's what you mean.

 

[Rob9876]

People that bleed out are dead and don't require amputation.

I'm assuming that's what you mean.

No, it's not. Mine was a question, directed to a specific person's statement, over 2 years ago.

 

[Colombia Dive Adventures]

This - tourniquet usage is now greatly encouraged for any bleed that is large enough to potentially result in hemorrhagic shock. So much so that if you look at a wound and think you might need a tourniquet, it’s appropriate to use a tourniquet.

It is difficult to fashion a tourniquet out of something not intended to be a tourniquet; it can be done, but it’s hard. Zip ties would be a very last choice as they are too narrow and cause local tissue damage.

I have never tried to put a tourniquet on someone while underwater. Im guessing it would be tough to do so. The compressibility of a wetsuit would also be a problem - I would cut it out of the way. My point to all of this is I would think that a tourniquet is something kept on a boat/shore bag, but not likely useful when submerged. I’d be open to being shown otherwise.

As far as Benadryl vs Epi 1:1000 - the question is what are you treating. For a simple allergic reaction Benadryl is the treatment. For anaphylaxis your treatment is epi. Benadryl is a far second. Sure both are nice to have, but Benadryl can wait for the shore, on a boat Epi could be lifesaving.

The above is from my two decade experience as a lifeguard, paramedic, RN, and now emergency nurse practitioner. I am not a rescue diver.

You bring up a good point about applying them in the water. We have not drilled this and we should. Our training has been done dry on the boat. I will give it a try on our next trip and let you know how it goes.

 

[Waterwulf]

I have carried a tourniquet on my dive harness since the early 70's. Back then, it was a steel cable with two wooden handles that looked more like a Garrotte than a tourniquet. Nowadays, I have a nice bright red "factory" one. I also carry one in my dry gear and all first aid kits. I have only ever seen one dive injury that required a tourniquet and I honestly believe that he would have died from blood loss without it. (It was squirting)

Bad stuff happens, it always happens fast and it doesn't always happen to you. I carry several items on my gear that (hopefully) will never see any use. A tourniquet, a light beacon, line cutter, a RBFK (That's R for really), a whistle, etc. I plan my dives to never use any of that stuff but plans go wrong sometimes and I have used some of that gear. Prop strikes and shark bites are bad but you can bleed out from more common injuries just as fast.