Skip to main content

Survival - All tourniquets are not created equal

Tourniquet-F

As the modern tourniquet establishes its rightful position as the gold standard of pre-€‹hospital bleeding control, manufacturers race to establish a foothold as "the" go-€‹to unit. There are some great items on the market that, when needed, can drastically change the outcome of an otherwise fatal event. For little impact on your wallet, you can save lives, possibly your own. But take note, not all tourniquets are created equal.

I recently had an exchange with an individual on the topic of building your personal medical kit. This is a vitally important dialogue for anyone interested in proactively managing the emergent situation. When the topic of tourniquets came up, this person who has no trauma management training or experience, boldly stated, "The ABC tourniquet is the best tourniquet on the market." I was somewhat surprised by the proclamation and had to ask him what experience he was basing this upon. The short version of the story sounded like a well-€‹articulated argument of a 14-€‹year-€‹old girl. "A friend of mine knows a (insert impressive credential here) that said so."

One-€‹handed application of C-€‹A-€‹T. For the arm, the strap is fed through only one slit of the buckle.


As a proud practitioner of critical thought, as I hope we all are, this dog simply doesn't hunt. Don't be pulled into the fan-boy standards of doctor, medic or instructor idol worship; we are talking about life or death here. To truly appreciate the market choices available, and make kit purchases tailored to your needs, we must understand the differing types, qualities and applications of the modern tourniquet.


It is, in my opinion, irresponsible to suggest that the TK4 is superior to the SOFT-€‹T, or the C-A-T is inferior to the SWAT. These are apples to oranges statements. This article is not about which you should buy, or what I prefer. This article is about what tourniquets you should evaluate for a specific use. Saying whatever tourniquet is the only option for you is great until that one isn't around and you're bleeding to death. I most certainly have my preferences, which are based on years of training and experiences on the street. I have very intelligent counterparts that disagree with my position. This is fine, as we train on what we use.

With years of experience as an instructor and fire lieutenant, I feel it best and more descript to break tourniquets into unofficial classifications. Placing tourniquets into one of the following categories best summarizes your options: Primary, Secondary and Improvised/Field Expedient.

PRIMARY 

A primary tourniquet will be the one most commonly used for pre-€‹hospital or military operations. The TCCC (Tactical Combat Casualty Care) standards designate recommended tourniquets, which represent the highest success potentials for pre-€‹hospital care options. These tourniquets will almost always, when applied quickly and appropriately, insure a stoppage of blood loss from arms or legs. (It should be observed that larger legs might require two tourniquets) It is a requirement that these tourniquets be designed for self-€‹application using one arm. Common examples of primary tourniquets would be C-€‹A-€‹T, SOFT-€‹T and the SOFT-€‹T Wide. These are generally the most expensive selections and will take up more room in storage than other types of tourniquet, but they unquestionably ensure the highest probability of success. Most reported failures of any model described in this category are the direct result of improper application, so be wary of overly disparaging positions. If you have room in your bag, or better yet on your belt, this is the direction to go.


Please remember that the C-€‹A-€‹T and SOFT-€‹T offerings, in almost all use potentials, represent the best possible tool for stopping of life-€‹threatening bleeding. Through clinical trials and field applications, the efficacy of these devices is known, which is why they are the only tourniquets recommended by the CoTCCC (Committee on Tactical Combat Casualty Care). Before making your tourniquet decision, beware of companies using creative wordsmithing in the representation of their product. "TCCC Approved" is not the same as "CoTCCC Recommended." Stick to the tourniquets mentioned above and you'll avoid this unfortunate issue altogether.

2€ƒThe C-€‹A-€‹T requires the strap to be fed through inner and outer slits of the buckle. The SOFT-€‹T options do not require different techniques for arm or leg application. Both are highly effective.

4€ƒExpect a pain response when tightening a primary tourniquet windlass.


SECONDARY

Properly applied primary tourniquet to the lower extremity. Note the high (proximal) positioning on the thigh. Remember, a larger thigh might require two tourniquets.

Next comes the secondary tourniquet. It is fair to say the secondary tourniquet represents the "it's better than nothing" option, akin to carrying a tiny .380 when you'd rather have a full-€‹size pistol. Much like the aforementioned handgun selection, if it's appropriate for your situation, the secondary tourniquet can meet the needs of uncontrolled extremity bleeding if you've mastered the device in training. Examples of these devices would be the TK4 or the SWAT-€‹T. These secondary tourniquets can be easily obtained for less than $10 and have a much smaller storage footprint than primary tourniquets.

Limitations for these devices will be immediately noted in one-€‹handed application or when applying to the leg. "Secondary" is an appropriate term because these options can act as a positive back-up to the C-€‹A-€‹T or SOFT-€‹T. In training, I pay a great deal of attention to the ability of a tourniquet to achieve blood flow stoppage, but I also work with each tourniquet to see how well it maintains the initial application. A patient drag, crawl, or continuance of previous action should not cause a tourniquet to release. Accidental release is a definite concern in the use of any secondary tourniquet, but I find it to be particularly concerning with the SWAT-€‹T product.

One manner in which the secondary tourniquets come into their own is concerning life-€‹threatening hemorrhage (otherwise not controllable) in a pediatric patient. For my personal gear selection, this is the only reason to carry a secondary tourniquet.

Improvised/Field Expedient

Your improvised or field expedient options are pretty commonly known. These are the tourniquets that many of us engineered for merit badges in our youth. There are some tricks that can result in a well-€‹crafted, highly-€‹functional tourniquet. My personal favorite is a standard ratchet strap, of which four are stored in the rear of my truck. Because I've trained on the ratchet straps, I know they could be pressed into service if the situation presented itself. The reality is, improvised tourniquets rely on you having specific items on your person at the time of injury or very soon thereafter. This is most often not practical. Betting a person's life on your ability to find that perfect strap or super-strong windlass at the most stressful moment of your life is a fool's wager. A belt, shirt or narrow piece of cordage applied to such wounds will almost always be fruitless. I mention this category of tourniquets primarily to convey a message that your other options are too simple, affordable and available to ignore.

I leave you with a final (and unsettling) thought. At the worst moment of your life, when you call 911 and expect a Paramedic or EMT to arrive and stop the blood flow, know that the vast majority of EMS agencies are forbidden to apply tourniquets.

My hope is that the information provided here will encourage everyone to seek knowledge through training and experience. In order to save lives, we must be proactive, not reactive.

Current Magazine Cover

Enjoy articles like this?

Subscribe to the magazine.

Get access to everything Guns & Ammo has to offer.
Subscribe to the Magazine

GET THE NEWSLETTER Join the List and Never Miss a Thing.

Recommended Articles

See More Recommendations

Popular Videos

Umarex Air Ruger 10/22 Rifle Review

Umarex Air Ruger 10/22 Rifle Review

In this segment of "Guns & Ammo TV," Gun Tech Editor Richard Nance and Pro-Shooter Jim Tarr head to the range to wring out the Umarex Air Ruger 10/22.

First Look: Springfield Armory Model 2020 Waypoint Bolt-Action Rifle

First Look: Springfield Armory Model 2020 Waypoint Bolt-Action Rifle

At the heart of the rifle is the Model 2020 action which wish designed and built with very tight tolerances thanks to Springfield's technology-driven manufacturing capabilities The stainless steel action features an integral recoil lug, and pairs with a fluted bolt employing dual cocking cams and an enhanced extractor for high pressure loads. The blueprinted and precisely machined action allows Springfield to offer the Model 2020 with .75" MOA accuracy guarantee. Despite being a production rifle, the Model 2020 should rival more expensive custom builds.

Savage Arms Impulse Rifle with Straight-Pull Action

Savage Arms Impulse Rifle with Straight-Pull Action

Savage introduces a must-shoot straight-pull rifle, the Impulse, with three hunting configurations.

Red vs. Green Lasers: Visibility in Bright Light

Red vs. Green Lasers: Visibility in Bright Light

In this segment of “At The Range,” Handgunning Editor Jeremy Stafford and contributor Patrick Sweeney compare the visibility of red and green lasers in outdoor, sunny conditions.

See More Popular Videos

Trending Articles

You might be surprised how many Americans (even gun owners) think machine guns are illegal.Machine Guns — Can You Own One? Rifles

Machine Guns — Can You Own One?

Eric R. Poole - December 15, 2020

You might be surprised how many Americans (even gun owners) think machine guns are illegal.

The story of a confederate sniper’s revenge and an exclusive look at his rifle.The Story of Civil War Sniper Jack Hinson and His Rifle Historical

The Story of Civil War Sniper Jack Hinson and His Rifle

Kyle Lamb - January 12, 2018

The story of a confederate sniper’s revenge and an exclusive look at his rifle.

Some guns are easier to work with than others, but the Ruger American Rifle doesn't require an engineering degree to tinker with; here's a look at some upgrade options to take your Ruger American to the next level, and make it something a bit different.Top Ruger American Rifle Upgrades Accessories

Top Ruger American Rifle Upgrades

Philip Massaro - March 15, 2018

Some guns are easier to work with than others, but the Ruger American Rifle doesn't require an...

Meet the Wilson Combat Protector: You get the experience of sound design and quality now in a more affordable package.Wilson Combat Protector Review Reviews

Wilson Combat Protector Review

Tom Beckstrand - March 24, 2020

Meet the Wilson Combat Protector: You get the experience of sound design and quality now in a...

See More Trending Articles

More Survival

The joint 5.11 Tactical and the North American Rescue UCR IFAK kit is a must have for any range bag, car trunk or residence.5.11 Tactical UCR IFAK - An Individual First-Aid Kit for Firearm Owners Survival

5.11 Tactical UCR IFAK - An Individual First-Aid Kit for Firearm Owners

Guns & Ammo Staff - September 06, 2018

The joint 5.11 Tactical and the North American Rescue UCR IFAK kit is a must have for any...

Key home invasion survival concepts to help you on your journey.Home Invasion Survival

Home Invasion

Tom Beckstrand - October 06, 2017

Key home invasion survival concepts to help you on your journey.

Our favorite nylon products for rifle shooters introduced this past year are from the good folks at TAB GEAR, a family-run business operating in Texas.Tab Gear Roundup Survival

Tab Gear Roundup

G&A Staff - June 23, 2017

Our favorite nylon products for rifle shooters introduced this past year are from the good...

If you asked any musher on the Iditarod Trail about their biggest worry, you may be surprised toGuns of The Iditarod Trail Survival

Guns of The Iditarod Trail

Peter B. Mathiesen - March 16, 2015

If you asked any musher on the Iditarod Trail about their biggest worry, you may be surprised...

See More Survival

Magazine Cover

GET THE MAGAZINE Subscribe & Save

Digital Now Included!

SUBSCRIBE NOW

Give a Gift   |   Subscriber Services

PREVIEW THIS MONTH'S ISSUE Arrow

Buy Digital Single Issues

Don't miss an issue.
Buy single digital issue for your phone or tablet.

Buy Single Digital Issue on the Guns & Ammo App

Other Magazines

See All Other Magazines

Special Interest Magazines

See All Special Interest Magazines

GET THE NEWSLETTER Join the List and Never Miss a Thing.

Phone Icon

Get Digital Access.

All Guns and Ammo subscribers now have digital access to their magazine content. This means you have the option to read your magazine on most popular phones and tablets.

To get started, click the link below to visit mymagnow.com and learn how to access your digital magazine.

Get Digital Access

Not a Subscriber?
Subscribe Now