Tourniquets Save Lives

Some content in this article might not be for the faint for heart, but required to understand if you want to save your life or lives of others.
It’s time that I write about one very important life saving device known as a tourniquet.
A tourniquet in your center console of your car,  or better, on your persons can increase your chance of survival in a vehicle crash that caused major arteries in one of your limbs to rapture. Consider this life saving advice. I can’t emphasize enough on this particular essential hardware. You should learn how to use one and practice how to deploy one from time to time.

I prefer the CAT (Combat Application Tourniquet) above all others mainly due to it’s reliability, ease of use and proven track record.

Let’s explore the history of the CAT Tourniquet from North America Rescue Products (NARP) website:

The Combat Application Tourniquet was initially fielded by USSOCOM in 2004 then fast followed by conventional forces in 2005. In the early years of the Global War on Terrorism (GWOT) and prior to the implementation of modern prefabricated tourniquets, the death rate from extremity exsanguination was 23.3 deaths annually. After full implementation, this number was reduced to 3.5 deaths per year, an 85% decrease in mortality. In 2005 the Combat Application Tourniquet was selected as one of the Army’s top 10 greatest inventions and is recognized as one of the foremost advancements in pre-hospital care during the GWOT with an estimated 1,850 lives saved.
Relentless comprehensive analysis of all deaths from extremity hemorrhage has resulted in evidence-based tourniquet improvements. This approach has yielded critical device improvements to include five refinements in the design of the Combat Application Tourniquet over the last decade. These enhancements were focused on maximizing the effectiveness of the device while minimizing morbidity.
Continuous interface with end-users and researchers, literature review and tourniquet applications in both real world and simulated high stress tactical environments have made it clear, that despite tremendous success, tourniquet knowledge gaps exist in the following areas (1) single verses double routing of the band (2) Importance of slack removal prior to engaging the windlass. Closing these gaps will be accomplished through device enhancements, knowledge products and focused training.
**GENERATIONS**

Gen 1:
To start off with we have the first generation Cat tourniquet which was only around for approximately six months in 2004. This generation will be defined only by its windless. The windlass on the first generation has five rings on each end compared to the three rings on subsequent generations up until the Generation 7. The first generation CAT had a 30 inch strap from the end of the tip to the end of the polymer stabilizer plate opposite of the windlass. This generation will also have a tapered 45° black tip unlike the rounded black and rounded red tips of later generations. As with all generations up until the fifth generation, the first generation will have a black Velcro locking strap to insure the windless doesn’t come undone.

Gen 2:
The second generation CAT will be almost identical to the first generation with the exception of only three rings on the windlass. This will be the last generation to feature the tapered 45° black tip.

Gen 3:
The third generation of the CAT features a raised middle bar on the buckle which aids in a friction lock for the strap when tightened. This generation is also the first generation to switch to a rounded tip, however it is still black. The length of the strap was also increased to 33 inches. This generation is the first to have any kind of date stamped onto the end of the strap.

Gen 4:
The fourth generation of the CAT is where we are first introduced to a rounded red tip. “Red Tip Technology” as NARP calls it, allows for quicker visual recognition of the end of the tourniquet. Another feature that we see on the fourth generation CAT is a thickened windlass. This came about after complaints from users of the windlass snapping when significant torque was applied. The fourth generation will be the last generation to sport the black locking strap.

Gen 5:
The fifth generation didn’t change much other than moving to a white locking “time” strap. The function of the strap didn’t change, however by changing the strap to a white color it allowed for users to be able to document the time that the tourniquet was applied.

Gen 6:
The sixth generation of the CAT saw the length of the tourniquet increased to 37.5 inches. This allowed for the tourniquet to be applied to a wider range of patients as well as more Velcro, which aids in the amount adhesion of the strap to itself, preventing it from coming undone. This generation also included additional manufacturing stamps on the strap which are a small picture of a factory and the word “Lot”.

Gen 7:
The seventh generation is the generation with the most improvements. The first and in my opinion the greatest improvement over subsequent generations in the single routing buckle. With previous generations when applying to the leg NARP instructed users to route the strap through both slots in the buckle to ensure a solid friction lock. With the redesign of the buckle in the Gen 7, this time consuming process is no longer needed. The second improvement was a complete revamp of the windlass. You’ll notice a significantly increased diameter, enhanced strength, and aggressive ribbing which allows for an improved grip the windlass clip was also redesigned with beveled entry on both sides and an increased thickness which adds more strength to the clip preventing snapping. The windlass strap was also changed from white to a grey color for a reduced signature during tactical use. The polymer stabilization plate opposite of the windlass has been reinforced and now has a beveled contact bar to minimize skin pinching. 

With extensive usage, track record, enhancements and redesigns as well as documented data on the field over seas and in the US. The CAT has been widely accepted and recommended by many well known firearms instructors and LE agencies in the country.

Consider taking Collapse Medicine course by Greg Ellifritz from Active Response Training. I’ve taken couple of his classes including the collapse medicine course which I learned how to use tourniquets the correct way.
Chances that you rapture an artery in a limb is higher than getting shot by a bad guy or having to use your gun. Think about it, besides car crashes, you might have an accident at work or home. Bleed out from the femoral artery takes about 2-3 minutes max depending on body size, distance from heart and movement.
Here is a GRAPHIC video showing a suspect take a single 7.62 to the thigh, with following femoral bleeding.
See the photo below of a recent incident where a careless gun owner shot himself in the leg. He didn’t have a tourniquet but lucky enough, a cop who had a tourniquet was able to save this man’s life just in time.

People love to talk and show off (pocket dump) their EDC gear but sadly missing a key life saving piece of equipment.
Many times tourniquet saved lives. Another example where an officer involved in a shooting who needed a tourniquet http://gunrights.trendolizer.com/2017/09/officer-caught-in-cross-fire-needs-tourniquet-to-survive-active-self-protection.html just listing a few examples.

Carry a Tourniquet 

There are several methods to carry a CAT as EDC item. The one way I carry a CAT is in my Ricci Ankle Medical kit on my ankle. I found this position and carry method to be the most optimal. I barely feel it’s presence and conceals well. Find your ideal carry position and method. Besides the tourniquet, I got a blood clotting gauze, a small roll of duct tape, and some steri strips.

Phlster recently came out with a Flatpack which can be attached to your belt or other locations. You can carry a tourniquet in places where you can’t carry your firearm. Such as through TSA security on your carry on 🙂 . What if you get attacked by a knife welding psycho? If your artery in your arms get cut, you need a tourniquet. Blood clotting gauze is helpful to stop other moderate bleeding that’s not an artery.

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