Field Guide to Tourniquets

Can’t we all just get along?
; .

Editors note — Welcome to the first installment of our new bi-monthly column “Everyday Carry.” Self-defense, self-reliance and preparedness are hot topics with our readers so we wanted to devote a little more space to the subject. Every other month we’ll have tips from our bevy of world-class experts regarding their take not only on guns and shooting for self-defense, but holsters, lights, packs, ammunition, knives and the million other things which fall under the category of “EDC.”


IBD — The Israeli Bandage Device

This is a pressure dressing often mistaken for a tourniquet. It’s great for treating massive bleeding and can be used in conjunction with a tourniquet — but it’s not a tourniquet.

CAT — The Combat Application Tourniquet

The CAT is the big daddy of bloodstoppers, the military-issue tourniquet of choice. Once chosen by the military, it drifted widely into law enforcement, EMS and fire service use, along with countless private citizens, rangemasters and shooters. It is also widely copied and modified.

The Good: Very effective when applied properly,widely available.

The Bad: You must train to use it beforehand. Believe it or not, lower-quality counterfeits are common.

Our esteemed cohort Tom McHale said something a while back I intuitively understood but could never put into words: “Shooters Are Binary.”

What he meant by this statement is the fact most shooters take a black/white, good/bad, yes/no outlook toward almost everything. Get a couple of firearms enthusiasts together, toss in a topic and watch the fur fly. One of those topics is my rant du’ jour — tourniquets.

During a recent discussion with the editor of another esteemed firearms journal over a few spiritous beverages, he bluntly mentioned a story I had written a few years ago on the subject of gunshot wound treatment was dead-wrong, especially in regards to tourniquets.

He stated his own expert in the field had seen the story and taken the article apart piece-by-piece based upon his own life experiences which, frankly, were far greater than my own.

After discussing the matter at length we decided to “agree to disagree” and have another toddy. This is what friends (should) do but the whole incident stuck with me as I realized when it comes to creating controversy, there might not be any topic this side of the whole “Wheelgun versus Semi” debate to inspire more profound, overheated disagreement than the matter of which tourniquet to carry for emergencies.

Having spent significant time over the years applying bandages and occasionally a bare hand to serious wounds, along with countless hours in training and discussion on the subject with a bunch of real “been there, done that” people, it’s apparent to me there’s a couple of dozen ways to skin this particular kitty — and most of them are effective.

Depending on whom you poll and which “camp” they fall into, there seems to be no common ground among the adherents of each type of tourniquet. In fact, the devotion to the different brands or styles is pursued with almost religious fervor — “I’m right and everybody else is wrong.”


SWAT-T — Stretch, Wrap and Tuck

This is essentially a giant stretchy band, simple to apply, compact and easy to carry. While on patrol, I always had one in my pocket, not because it was the single most effective but because it was compact and could buy time until better equipment arrived.

The Good: Anyone can apply, extremely compact,one-third the price of other types.

The Bad: Not as effective as other types,hard to apply one-handed, can easily come loose.

I know people who have treated countless gunshot wounds with every particular flavor of tourniquet and many will tell you their personal favorite is the only suitable type on the market, bar none. Furthermore, they will give you compelling data and practical examples of why they are correct.

It was after many such conversations I began to realize each of them was right, maybe a little wrong and wholly somewhere in-between.

The experts don’t hold their beliefs as a matter of pride, capitalistic avarice or simple pig-headedness. My sources have all been thoughtful, intelligent and highly-driven in their goal to save lives. Rather, I think the whole debate falls under one of my favorite sayings — “Your Mileage May Vary.”


RATS — Rapid Application Tourniquet

The RATS is a favorite because of its simplicity — it’s basically a big rubber band with a cinch tie at the end. However, unless you don’t have anything else handy, a length of shock cord is not an acceptable substitute.

The Good: Easy to apply even if untrained,no moving parts, less expensive than the CAT.

The Bad: Not easy to apply one-handed.

Other Types — Rachets to Rope

Some tourniquets, such as the rachet type, are extremely effective while others such as rope, belts and scarves are nearly useless. Whatever you decide to carry, make sure you know how to use it and have it available whenever taking part in hazardous activities such as shooting, woodcutting — or arguing about tourniquets!

That’s because individual situations, training level, age, prior experiences, patients, external support system and even weather play a role in developing the opinion and conclusions of experienced professionals. This is why two experienced gunfighters will never agree on the single “best” pistol for social work and two medics will seldom concur on the very best way to treat a gunshot wound.

Boiled down, here’s my point — if the experts can’t come to some kind of consensus, we mere mortals only get confused when we start listening to all the well-intentioned but contradictory advice. Therefore, my simple mind has come to rest somewhere between the various extremes.

I don’t believe it’s necessary to get completely lost in the idea of finding the single, best, all-purpose tourniquet to stuff into our first aid bags and “blowout kits.” We don’t need to get wrapped around the axle worrying about the differences between the CAT, RATS, SWAT-T or The Mincing Wombat tourniquet, now available in floral pattern. They all work for better or worse but none will save a life unless you have it handy and the intestinal fortitude to use it if lead meets flesh.

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