Tactical combat casualty care ( TCCC )

[Dale Turner]

I agree whole heartedly, the TCCCC should be a CF standard course just like FA is or SHARP is.

The problem in the reserve world is that we're so busy keeping ourselves qualified with MCSP and trying to fit some ex's in there as well that there is no time to a) take the course/instructor course, b) there is no time to teach it to anybody else.

And I've said in some other medical threads needle decompression is not that hard of a skill to learn. I think land marking and assessment of a pneumo. would be the toughest part to learn.

I agree and have stated that some CFMG people dont have the heart for the combat stuff but what do you suggest would remedy that?





DT

 

[Armymedic]

And I've said in some other medical threads needle decompression is not that hard of a skill to learn. I think land marking and assessment of a pneumo. would be the toughest part to learn

Yes, but not nearly as simple as the two other skills which are more likely to save lives, AND not nearly as invasive:

Tourniquets and,
Nasal Pharyngeal Airways.

Given the choice, I'd have every member of the CF instructed on tourniquet techniques and issued one with their fd dressings.

 

[KevinB]

Good point.

As far as the NPA goes -- I always wanted to do a emergency tracheostomy/tracheotomy  ;D

Some rubbing alchol on a bic pen (ink section removed) and voila intanct trach tube - and trusty knife cut for a stoma.
This was actually touched on by the CF MO teaching OPA/NPA's as well...

* I got a copy of a buddies SF Med book - watchout here come Dr. Death 

 

[Armymedic]

Kev, using a bic pen cylinder to do a emergency trach would be the equivilent of you using the normal service C7A1 vs your own rifle in a shooting competion. As it, it would work, but why when much better kit is avail?

Way cool to try, no doubt, but that is not a "tactical" medical procedure.

 

[KevinB]

No - but as you said "cool to try..."

  ;D

 

[Dale Turner]

Armymedic, Good point re; tourniquets however some medics dont even have a good working knowledge of tourniquet use.

Do you know of any plans of aquiring proper tourniquets. I'm sure our regular IV tourniquets will work in a pinch but like you said why not use the best kit available.

 

[Fraser.g]

Armymedic, Good point re; tourniquets however some medics don't even have a good working knowledge of tourniquet use.

Do you know of any plans of acquiring proper tourniquets. I'm sure our regular IV tourniquets will work in a pinch but like you said why not use the best kit available.

Although I do not have any knowlage on the CF purcurment of new equipment I do know that a regular IV tourniquet is not sufficient. They are designed to arrest venous flow not arterial.

You would be better off with a 1 inch cargo strap and a winlass then using a penrose drain or other IV tourniquet in a situation where direct pressure or pulse pressure points will not arrest the flow.

GF

 

[Dale Turner]

See what I mean? ;D

Maybe tourniquet usage SHOULD be taught during QL3 or PHTLS.

Thanks RN RPN




DT

 

[Fraser.g]

Here is a site with the best explination in laymans terms the indications and contraindications as well as the usage and maintainance of a tourniquet once it is applied.

By the way the VNH is a fantastic resouce for anyone who is interested in military medicine. IMHO.

http://www.vnh.org/StandardFirstAid/chapter3.html

GF

 

[medicineman]

I was doing a search on CMED's site and found that there is a CF NSN for the CAT - Combat Application Tourniquet - which is on issue with the US Army.  Apparently a bunch were procured for ROTO 4.  It looks like a decent device - quick application with a windlass built into it.  NSN is 6515-CF-001-9812, Tourniqet Combat Application, Hemorrhage Control.

Someone brought up using an IV TK - you'd need alot of bulk underneath it to get the pressure you'd need to get good arterial bleeding control - better off using a BP cuff.

MM

 

[Armymedic]

I was doing a search on CMED's site and found that there is a CF NSN for the CAT - Combat Application Tourniquet - which is on issue with the US Army.   Apparently a bunch were procured for ROTO 4.   It looks like a decent device - quick application with a windlass built into it.   NSN is 6515-CF-001-9812, Tourniqet Combat Application, Hemorrhage Control.

In fact it was for Roto 3. In practice they're slick and easy to use.

2 Fd Amb is teaching another course in Jan.

RN PRN,
I used same reference cut and pasted into a PP lecture I did a while back...simple and direct.

 

[Old Ranger]

Any chance there available in CIVI land?

 

[Old Ranger]

Any chance there available in CIVI land?

Disregard, found in Medical Forum, under U.S. First aid Kits.

 

[Armymedic]

From website:
http://www.phildurango.com/index.htm

Combat Application Tourniquetâ„¢
(C-A-T)â„¢
   
The C-A-Tâ„¢ is the 1st choice of the U.S. Army, the Army Surgeon General, and the Army Institute of Surgical Research.

The Combat Application Tourniquetâ„¢ (C-A-Tâ„¢) (Patent Pending) is a small and lightweight one-handed tourniquet that completely occludes arterial blood flow in an extremity. The C-A-Tâ„¢ uses a Self-Adhering Band and a Friction Adaptor Buckle to fit a wide range of extremities combined with a one-handed windlass system. The windlass uses a free moving internal band to provide true circumferential pressure to an extremity. The windlass is then locked in place; this requires only one hand, with the Windlass Clipâ„¢. The C-A-Tâ„¢ also has a Hook-and-Loop Windlass Strapâ„¢ for further securing of the windlass during patient transport.


Combat Application Tourniquetâ„¢
(C-A-T)â„¢
   
     
Product  Tourniquet Combat Application One-Handed
NSN: 6515-01-521-7976
Part Number: NAR-CAT 
 
     
Distributor  North American Rescue Products, Inc. is now the exclusive U.S. distributor for the Combat Application Tourniquetâ„¢.

www.NARescue.com
info@NARescue.com
888.689.6277

 

[2Charlie]

I am in a place where the Tq is a must have piece of kit.

Most of the guys I am with ditched the CAT and went with a very simple design that pulls through a buckle and then you pull a lanyard that snaps a ratchet closed.  One handed, and fast.

The CAT is good, but you better not be on the down side of fading on a bleed out reading the freakin directions.

 

[Fraser.g]

I am in a place where the Tq is a must have piece of kit.

Most of the guys I am with ditched the CAT and went with a very simple design that pulls through a buckle and then you pull a lanyard that snaps a ratchet closed.   One handed, and fast.

The CAT is good, but you better not be on the down side of fading on a bleed out reading the freakin directions.

2C

Do you know the name of the TQ you and your friends have? I would be interested to get your feedback.

Also, no piece of kit shuld have its instructions read in the instant you need to use it.

Hmmm "in case of miss fire cant the weapon to the left and note the position of the bolt (Ref A)"...

GF

 

[JANES]

You need to be careful.  Look at the data.  Theres been alot of testing done (the the US and CDN Militaries) that says the only effective ones are the CAT and the SOF-T.  Hence why they are the ones that are issued now (US).  The one you have may be easier to use, but unfortunately thats not the only criteria for an effective tourniquet.  It needs to stop arterial bleeding completely, or you could be doing more harm than good (lets blood out, but none back in - better to let none out or in).  And you need a doppler to test this, not simply a loss of distal pulse.  All I'm saying is be carefull - check the data before you decide something is "better" - it may be a relative term. 

 

[JANES]

I am in a place where the Tq is a must have piece of kit.

Most of the guys I am with ditched the CAT and went with a very simple design that pulls through a buckle and then you pull a lanyard that snaps a ratchet closed.   One handed, and fast.

The CAT is good, but you better not be on the down side of fading on a bleed out reading the freakin directions.

The tourniquet described here is the SATS - Self Applied Tourniquet System.  It was one of the ones the the US SF initially started using, as well as one of the ones trialed on the TCCC pilot course.  Since the testing has been done on it, as well as many others, it was proven to be ineffective.  Very ineffective actually.  If you go by the data from the studies - the ones recognized as effective by the Canadian and the US studies (Military) are simple surgical tubing (not penrose drains) (also, one handed application problems and securing problems) the CATS, EMT which is the same idea as the CATS in a bulkier heavier design, and the SOFT-T recommended for medics because it's bulkier and heavier but better tolerated by the casualty as it is pneumatic.  The idea being that self/buddy aider applies the CATS then when the Medic gets to them may apply a SOFT-T.  There are tons of other ones out there, but the cooler looking one, or the easier to put on one might bight you in the bum in the end.  Stay safe!

 

[JANES]

A correction to my previous post.  I mixed the SOFT-T and the EMT up.  The EMT is the pneumatic tourniquet that the medics should carry, and the SOFT-T is the one that is similiar to the CATS only heavier and bulkier.  Again though, these were the only three found to be effective. 

 

[rhino18]

LDTFS has completed the QS for this course and it looks very similar to the courses run by 1CMBG.  This will include not only theory, A&P, Dx, and Rx.  But most importantly the field time to produce the stress imoculation required to be effective under tactical conditions....