# Minister of National Defence Visit to 2 Fd Amb.



## Armymedic (13 Apr 2006)

Guess what I did today?

The MND came for a visit to 2 Fd Amb. He got to converse with some of the troops from HSS who are training to go in Aug. He was shown two demos of some of the medical gear the deployments are getting, Quickclot and CAT tourniquet (CAT presented by yours truly). Then he saw a demo of a trauma scene including this new kit and finishing with the loading and actions while on the road in the new Bisons Amb. (it was a static display for the media)

Afterward he addressed the troops, and held a press conference.

I had 5 mins for my brief, and talked about the history of the CAT and the studies of why it was the preferred model. The I discussed about how a tourniquet works and why and where you put one on. The before I demo'ed the use, I asked if he had any questions.....Proper instruction, but in this case, mistake. Being an old general he asked about the risks of losing the limb and when you remove it, which was part of the brief I was deliberately leaving out for the benefit of time, as it is 50% of my normal 10 min theory portion when I teach the class.   :-[
I turned a shade slightly lighter then my beret, as I got flustered by his pointed question, one I did not expect....My fellow Sr NCOs were razing me hard at the mess this aft over beer.

I got to admit, he is keen. Personally, I have never seen the man before in person, and I was impressed.


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## DartmouthDave (14 Apr 2006)

Hello,

I always hate when I get flustered!!.  Like blanking on a patient’s name at a receiving facility in front oh his nice family.  After, a looooong transfer in!! :-\

When I was in school I saw a total knee replacement done.  The tourniquet was on for 46 min.  There was only oozing at the knee during surgery.  So, I think one could leave on a tourniquet for quite awhile if the bleeding is arterial and catastrophic..  

Isn’t the standard to loosen it q10min?


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## Hot Lips (14 Apr 2006)

My understanding from the docs in ER is it is on 10min and then off and a short time (based on the status of the bleed) and then back for another 10min...is it not necrosis that sets in after an extended period of lose of blood flow? Which kind of defeats the purpose of the tourniquet if you are supposed to be preserving life and limb.
Although if you have to choose life over limb you know how that story goes...
As well a complete amp (as per St. John Ambulance) is not supposed to bleed in excess...

I think the best course of action is an at hand assessment of the situation...and carry on from there...

It is 0312 though and I ought to be sleeping...so excuse PRN
HL


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## kj_gully (14 Apr 2006)

Put the TQ on as low as you can, and leave it on. I asked these questions to doctors who were receiving TQ'd pts w/ 2 hour+ evac, and they said it was not an issue. If you put it on the guys brachial artery for a severed wrist, that's just poor care. Janes, Army medic, any thoughts? RNPRN, I'm sure you have a few.


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## Fishbone Jones (14 Apr 2006)

So, are we talking about the application of a tourniquet, how to teach it,.........or the fact that we finally have a MND that knows the real perils of a soldier and how to possibly address it? How fresh to finally have someone in Parliment that actually knows something about soldier first aid. Never mind what a tourniquet is, and how it's applied.

It's not a heartache getting flustered in training. That's what training is about. You train to where it becomes instinctive. That's why they call it training. Simply put, train enough to the point where you don't get flustered. If, as you did with the MND, you fell apart, you need more training.


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## Armymedic (14 Apr 2006)

No, I did not drop the ball, I had only taught the class just under 50 times in the last 4 weeks after all...I just got red and shaky. Its hard not to when you are talking to the MND, you have your entire Chain of command from Brigade commander down watching, and 5-7 TV cameras lights on you, and there are microphones hanging above your head. Remember there is quite the crowd. Still, that didn't stop my peers, the CSM and RSM to come aboard me in jest at the mess afterward.  :nana:   :cheers:

As for the loosening of tourniquets:
you never remove a tourniquet, it stays in place, it is only loosened.

If applied during care under fire, where it is applied for any and all penetrating trauma to the limbs: in the CCP or a area of relative safety, apply direct pressure to your wounds, and loosen the tourniquet to see how bad the bleeding is. If it is spurting, or soaks through the dressing retighten the TK.

TK may be applied for any bleeding from a limb that is not being controlled by direct pressure (spurting blood, amputations fall under this by default). You apply the TK. You may apply Quick clot if you have. And after 2 hours, you may loosen the TK to see if the bleeding is contolled. If it is not retighten, and do not attempt again.

Med Techs have different protocols (after more then 15 mins based on pt condition). And in medicine, its life over limb...TKs do that.

Like I said, I was impressed he asked such a direct, educated questions. I was extremely impressed he asked the questions he did, and his interest in those of us who get busy when people get hurt. We medical people tend to be the after thought (and rightly so) when commanders plan missions, so its nice to see the MND coming to see we have our stuff wired tight.

And after all, he did come to the best medical unit in support of the Army.  ;D


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## vonGarvin (14 Apr 2006)

Army Medic
Listening to the cbc news last night, I heard the MND ask that question, but they didn't play your response.  So, I guess you're "sorta" famous 


Garvin out


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## medicineman (16 Apr 2006)

Makes me wonder why they left that answer out - trying to make it sound like we`re going to have a bunch of cripples or amputees come home from extremity wounds perhaps? :

MM


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