“It is important to point out that he applied a tourniquet himself because he was bleeding profusely,”. Philadelphia Police Commissioner Richard Ross
A young Philadelphia, Pennsylvania police officer will live to return to duty after being shot through the upper thigh by a thug trying to steal a car. While attempting to apprehend two car thieves, Officer James McCullough was shot by a suspect. Recognizing the life-threatening injury, Officer McCullough applied a tourniquet to his own leg and arrived alive at the Emergency Room. At press time he is expected to make a full recovery.
This is not the first time an American law enforcement officer has used a tourniquet to save a life after being shot by a thug. A Boston police officer saved his partner’s life by applying a commercially made tourniquet. Boston started issuing TQ’s to road officers after the Islamic Terror Attack on the Boston Marathon.
Mississippi Governor, Phil Bryant, recently endorsed traumatic life-saving training and tourniquet use after a Mississippi law enforcement officer’s life was saved by those very things. Even the Department of Homeland Security is promoting tourniquet use via a program they are calling “Stop the Bleed.” Though, in typical government fashion, their recommended procedures are ten years behind the times. At least they have good intentions.
Despite more than a dozen years of successful use during the Global War on Terror, a U.S. Army study that fully and completely endorses rapid applications of tourniquets in the field, and mounting evidence from the American streets, there are still those who are afraid of the dreaded tourniquet.
Those who fear the tourniquet or believe that it should only be considered for use by “the professionals” fail to understand two basic concepts:
1) Good guys can and do bleed to death, and not just from gunshots. High speed vehicle collisions often result in severe trauma, to include partial and complete amputation of limbs. Shattered bones in the arms and legs can and will tear open arteries.
2) If a person has a compromised artery in a limb, only the people on the scene will have the ability to stop the traumatic bleeding injury and prevent the victim from going into irreversible shock. An uncontrolled arterial bleed will cause a patient to lose enough blood to achieve irreversible shock, in minutes, not ten to twenty, but four to five.
If an ambulance arrives in five minutes, and that is fast, the patient with an open artery will already have lost enough blood that no amount of medical treatment can save their life. Holding their hand and telling them the medics are coming will not save their life.
An improvised tourniquet (TQ), made with cloth, a belt, or some other material plus a stick, screwdriver, etc. can stem life-threatening blood loss. The problem with the improvised TQ is twofold; first, you need to decide that a TQ is necessary. Then you need to spend precious time locating the material and fabricating the improvised TQ. The other downside of the improvised TQ is that you must come up with a sure way to secure it. How much blood is the victim losing while you are searching for material and making an improvised TQ?
Actual field use of improvised TQs in combat environments found that often they were not tight enough to stem the blood loss or they came loose after being applied. Making an effective improvised TQ is a learned skill and must be taught and practiced. That being said, if improvising is all you have, go for it.
Thanks to the lessons we have learned since 9/11/01, there are numerous makes, models, and styles of commercially made tourniquets. They all have their own special features. By and large, any purpose-made TQ is head and shoulders better than making one with a belt and a stick.
Depending on the make or model, a ready made TQ will vary in price from $10 to $40 dollars. Basically, we are talking about an object that is very near in price to purchasing a spare pistol magazine for your favorite Glock or Sig. Aside from the “Ranger Ratchet”, a commercial TQ is also lighter and more compact than a pistol magazine.
The TQ included in the Pocket Life Saver Kit is shown to the left.
Just as buying a gun does not give the skill to use it to save your life, buying a TQ does not give you the skill to apply it during a life-threatening emergency. You need to have some type of skill to go along with your gear. Skill and gear go hand in hand. An IDPA Grand Master with their gun locked safely away in the trunk of their car is little more use in an attack than the average person on the street.
You need both skill and gear to support the skill. There are several reputable schools that administer medical training. You can check out the medical classes we teach here at Student of the Gun University (SOTG-U) by clicking here.
The issue many highly trained medical providers have is that they get so good as using their gear that they acquire a whole pack full of it. They have tourniquets in their rescue bags and backpacks. Again, if that bag is locked securely in the trunk of a car, it does little good when someone is lying at your feet bleeding to death.
After going through the Tactical Combat Casualty Care (TCCC) training course and then becoming an instructor for that program, I habitually carried a serious “blow out kit” attached to by backpack. I took the pack everywhere I traveled.
During a trip to shooting range several years ago I was glad to have my kit when a shooter on the range detonated a double-charged .30-06 handload. I was able to put my skill and gear to use bandaging his wounds. Happy ending.
However, a year or two later, I found myself as a guest at a national shooting sports event. My pack traveled with me. However, it was a hot day. Thus I decided that, as I was just observing, I didn’t need to lug it around all day with me. My pack and medical gear were secured in friend’s car.
Before noon there was a person with a negligent gunshot wound laying at my feet. My super-gee-whiz trauma kit was hundreds of yards away locked in a car. I was forced to improvise. The entire time I was waiting for the EMT’s to arrive (15 minutes or so) I cursed my decision.
The story had a relatively happy ending as the patient was not in mortal danger, only venous bleeding, not arterial. That did not make me feel that much better for my failure to have the gear I needed to go along with the my skill.
That incident also occurred within few months of the Boston Bombing and I knew that I needed to do better. If you listen to Student of the Gun Radio you know that is how the Pocket Life Saver kit came to be.
You carry a gun because you know that the police cannot be everywhere. Thus, you may need to save a life before they can arrive. That exact same thinking goes into learning traumatic life-saving skills and carrying the gear.
If you are willing to take a life in the “gravest extreme” but cannot make the commitment to save a life, I would suggest that you have some serious soul searching to do.
In the end, the choice is yours make. If someone you love is laying at your feet and their precious blood is leaking out onto the ground, you will want to do something. The big question is, will you have the skill and the gear to do something effective?
Professor Paul Markel
Latest posts by Professor Paul Markel (see all)
- Liberalism Kills - March 28th, 2023
- Examining the Citizen Soldier - March 16th, 2023
- Beretta ARX100: Ahead of its Time? - February 9th, 2023
- Disspelling the Tourniquet Boogeyman [Updated] - January 23rd, 2023
- Community Prepping and Communal Living [Updated] - December 29th, 2022
SInce you have the background and obviously are researching more than I am on tourniquets, do you feel that there’s a tendency to rush to its use? I’ve been in EMS since ’84 (not counting Scouts and Lifeguarding) and wonder if we are forgetting the basics.
How much blood do we want on the ground?