Accident Scene Management / Road Guardians

Life Over Limb – Tourniquets

Tourniquet

ASM Student Bob Slone from Ohio sent this story and a question related to tourniquets. ASM Founder and Author of “A Crash Course for the Motorcyclist” , Vicki Sanfelipo, RN/EMT answers:

Bob:Tourniquet
I heard a story yesterday that I thought would be of interest to you. A young lady who does scheduling and paperwork at a new dentist I am seeing shared about an accident she had last July. She was driving her car when her car broke down. She pulled well off the road and as she stepped out of the driver side door, she was struck by another driver who was driving under the of influence of alcohol. The impact took one of her legs off at the knee. Some guys in a pickup truck stopped to help and immediately went back to their truck to got a zip tie that they used as a tourniquet. They may have put something under it first, I don’t know. Anyway, the ambulance didn’t get there for 15 minutes!!! She credits the guys who stopped to help with saving her life. The surgeons cut off the stump a couple inches above the knee and she now has a prosthetic leg. She stated that it didn’t hurt until they got her into the ambulance.

I just got some extra heavy duty zip ties (they are wider than normal at Home Depot) to put in all my vehicles and my motorcycle trauma kit. You can get them 24″, 36″ and 48″ long. They don’t take up much room and could be used for other emergency purposes as well. They would certainly be faster to install then using a belt and stick. One could roll one of those cloth triangular bandages to put under the zip tie to keep the zip tie from cutting the flesh.

Any comments?

Vicki:
What a traumatic event that young lady you met had! A person can bleed out very fast and vessels in the leg are larger as you learned in class making preventable bleeding out from limbs likely in a situation like the one you described.

Bleeding016_400x384Now regarding the use of a zip tie. I know you said you found wide bands. I would still be concerned about how that would dig into tissue. Certainly you understand the need to pad it and that is why you suggested putting a triangular bandage underneath. Because, even with that little bit of padding the zip tie is still likely to cut into the tissue and can not be backed off if too tight (even hard to cut off once the person gets to the hospital) it concerns me to recommend that item as a “good” idea. Certainly the people who talked about how they had to find something to use in her situation understood enough to know a tourniquet was needed and that was what they found. Our goal would be to attempt to save the limb while applying a tourniquet. The recommended process is to use a wide soft band and apply just until bleeding is controlled. In class I showed how to use the Triangular bandage sometimes called a cravat to create a tourniquet. This $1.00 item should be in every first aid kit you own. You should try to control bleeding through Direct Pressure, Elevation (if no suspected broken bone) and pressure point if you know how to do that. If those things don’t work a tourniquet should be applied using gradual pressure until the bleeding is controlled. Be sure to write the time that the tourniquet was applied on the tourniquet or on the person’s skin next to the tourniquet. Once the tourniquet is applied do not release the tourniquet, leave that to the professional rescuers.

Here is a one minute video about the CAT (Combat Application Tourniquet) that I mentioned in class. There are other versions that you can view once you take a look at this one but it gives you the idea.

[fullscreenvideo videourl=”https://www.youtube.com/watch?v=Hz9qdjaHLVU”]

Thanks for giving me a chance to comment 😉

Bob:
For those of you I copied, Vicki Sanfelipo is one of the founders and chief instructor for an organization called Road Guardians (roadguardians.org) that trains motorcyclists in accident scene management and emergency treatment of motorcycle accident victims until the EMT’s arrive. Often early intervention by bystanders can save a life as the story above illustrates. That young lady would have bled out and died long before the ambulance arrived as a result of her femoral artery being severed. Motorcyclists involved in accidents often have injuries more traumatic in nature from motorists in accidents. I highly recommend that all my motorcyclist friends take their courses (you might save my life). I had to go to Ann Arbor, Michigan to take my previous course. This time it was offered at Powder Keg Harley in Mason. I first met Vicki at Bike Week where she was giving a lecture on accident scene management in the Convention Center at Daytona Beach. I just happened to be strolling by as I was checking out the vendor booths and stopped to listen. As I recall there was only one or two people listening to her but she was carrying on as if there were hundreds in the audience. I was so impressed by her presentation that I later took the basic and advanced courses that they offer.

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