I doubt it applies as much for the regular audience here at Cheaper Than Dirt!, but the Boston bombing was a wake up call for much of America. After all, I doubt many of you reading this hope there is someone in your area with a firearm to protect you if your house was about to be robbed and you were inside. Most likely, you would be prepared to be the last line of defense and protect yourself and loved ones. Likewise, in the event of a catastrophe you would likely be prepared with a cache of water, food and medical supplies. However, philosophies change and supplies need to be occasionally rotated, replaced or added to.
Recently, I was catching up on some of the latest chatter and after-action reports of the Boston bombing to see what insights I could gain. One particular detail really caught my eye when reading about the medical services offered at the scene—tourniquets. Given the proximity to local emergency services and the severity of the casualties, tourniquets were used en masse by many accounts.
In subsequent discussions with like-minded friends, most were under the impression—prior to the bombing—that tourniquets were taboo and had been for decades. A little research revealed the use of tourniquets traces back as far as the Roman Empire and were popular during most of the 1800s and 1900s. It wasn’t until the Vietnam Era that doctors came out against their use and most of that was due to a perception that the tourniquets were responsible for the amputations. It’s true, some were misused and attached too high unnecessarily sacrificing tissue and others were not tight enough, which can actually increase bleeding, but lives were, and are, being saved by the use of tourniquets.
I remember my training in the proper use of tourniquets during the first Gulf War in the early ’90s. Back then, they taught you to use a tourniquet with the understanding that doing so meant you had sacrificed the limb with little or no hope of saving it. That was an after effect of Vietnam-era thinking. Fortunately, for many of the victims in Boston, conventional wisdom has changed in the last decade and the proper use of tourniquets was credited with saving many lives.
The Boston bombing got me to thinking about my own medical kits. I have several first aid and trauma kits I collected over the years. I acquired some kits from military surplus while others were commercial offerings. I was shocked to inventory most of my kits and see, or more often not see, a tourniquet. As a substitute I do, however, have a healthy supply of Israeli compression bandages strewn about my kits. Even my go-to kit that includes everything to start an IV; a kit I have carried when traveling internationally to remote areas of Third World nations where medical supplies may have suspect did not have a tourniquet.
Overall, I would say I am not that concerned and know how to fashion a tourniquet quite easily from items I normally carry such as a belt, shirt or other material; but there is still the matter of knowing when and how to use one. Also, I would prefer to have one of the commercial offerings available that makes applying sufficient pressure easy and are guaranteed to be at least the recommended 1.5 inches wide.
I am not a medical professional, nor do I have the slightest desire to give medical or first aid instruction—especially when it has something to do with a life saving technique. However, I do know John Wipfler and he is qualified. Dr. Wipfler is an emergency room doctor and supports a handful of different SWAT teams as a tactical medic. He is also a leading author on the subject of tactical medicine. I recently had the opportunity to sit through one of his classes and was blown away by the amount of knowledge and the changes in first aid over the years. I suppose it makes sense. How many times have the recommendations for CPR changed over the last few decades? Getting back to the point, Dr. Wipfler is going to tackle medical topics for Cheaper Than Dirt! in the near future. The hope is to get bite-sized pieces of information that will help you become better prepared for an emergency.