Stock multiple types of tourniquet or focus on one?

Started by Optimist, August 18, 2022, 07:16:31 PM

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Optimist

I've been meaning to buy a few tourniquets for a while now. From my reading there are three main ones that are recommended:

C-A-T: Good tourniquet that is the easiest to put on one's self.

SOF-T: probably the best tourniquet but not as easy to self-apply

SWAT-T: not as good as the other two, but cheaper, lighter and more packable

I'm thinking I'll pick up a C-A-T for EDC. What I'm wondering is if it would be better to only get the C-A-T that way I only have to practice with one type? Alternatively I could EDC a C-A-T, keep a SOF-T or two in a larger FAK in my house and car for potentially helping others and get a few SWAT-Ts for stashing here and there so there should hopefully always been tourniquets nearby. That would mean I would be using the best aspects of each, but on the downside I would have to practice with each.

Right now I'm leaning towards just getting one kind, but I haven't made up my mind.

(I was taught how to use a tourniquet in a first aid class, but I'd like to find a Stop the Bleed or similar class because that part of the first aid class I took felt a little rushed and inadequate.)

majorhavoc

Buy one type and train to use it properly.
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MacWa77ace

The thing about the SWAT-T is that it is also a 'pressure dressing'.

Get either CAT or SOF AND some SWAT.

Another way to think about it is that the windlass models are a bit Kit specific and the SWAT's can go into any Back Up, BOB or Vehicle bag, back packs, tool boxes, tackle boxes, BOAT bags. To be used as a primary or secondary TQ or as a pressure dressing.

I have CATS in TCCC IFAKs, Medkits. And also attached to some equipment where, even if I have the IFAK with me, those only have 1 TQ in them, but what if 2 or more are needed. So some redundancy with CATs and SWATs.

I don't think SWAT are that difficult to self apply. Think hereon junkie. If they can do it ...

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echo83

Another vote for buy one and train. 

I carry a 4" Israeli bandage and a SWAT-T everywhere. I've used the Israeli twice, and yes, I know it's not a tourniquet. The SWAT-T is basically an oversized strip of rubber, but it's cheap, easy to carry, and has many other uses. It takes longer to apply, though.

I've had a CAT slapped on my leg by a first responder before. It took him seconds to apply, and was incredibly effective. (Instant pins and needles feelings around the application site, followed by a cold-feeling leg and stoppage of blood loss.) 

I had put on the Israeli by the time he got there, but that's kind of beside the point.

NapalmMan67

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Optimist

At first I was leaning towards only getting one to simplify training, but now I think I'm going to get at least one SWAT-T to experiment with. Mac makes a good point about it also being a pressure dressing. I've also read they can be handy for children or very small people who regular tourniquets are sometimes oversized for (I don't know if this is true, just something I've read a few times).

I do have some Israeli bandages, but having something multi-purpose is appealing.

MacWa77ace

Quote from: Optimist on August 22, 2022, 05:58:31 PM[...]
I do have some Israeli bandages, but having something multi-purpose is appealing.

I make my own compression bandage 'kit's'. [sort of, I carry the components that can be used identically to and IB]. Israeli bandages are expensive in comparison to what can be 'made' to do the same thing an IB can do, and yet be way more versatile.

While the Israeli compression bandages have more than one use, they are pretty specific for lacerations at >4" [or you'd need two]. They are faster if used for their specific intent. But they are not cost effective for some of the 'other' things they can be used for IMO.

So I just keep an ace bandage, two rolls of gauze, and some Celox as my 'compression KIT'. If you buy the components in bulk, it comes to a ridiculous savings over IB's. I feel the advantage of having a kit composed of an ace bandage, gauze and quick clot is that you don't have to use all the components if you don't need to. For example if you need to immobilize a wrist or ankle or shoulder use just the ace. If you need compression use the gauze in their rolled form under the ace. And you can decide if need to use the quick clot or not. If you need to 'pack' a wound or cover a 'road rash' scrape you can use the gauze, but gauze is also good for lots of other things than bleeding. I keep some compressed gauze also, because you can never have to much gauze.

These 'kit's' will compress down nicely when vacuum sealed so they don't take up more room than an IB if your worried about space.

Components:


YMMV

MAC MOD TCCC IFAK

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echo83

Quote from: MacWa77ace on August 23, 2022, 10:42:59 AM
Quote from: Optimist on August 22, 2022, 05:58:31 PM[...]
I do have some Israeli bandages, but having something multi-purpose is appealing.

I make my own compression bandage 'kit's'. [sort of, I carry the components that can be used identically to and IB]. Israeli bandages are expensive in comparison to what can be 'made' to do the same thing an IB can do, and yet be way more versatile.

While the Israeli compression bandages have more than one use, they are pretty specific for lacerations at >4" [or you'd need two]. They are faster if used for their specific intent. But they are not cost effective for some of the 'other' things they can be used for IMO.

So I just keep an ace bandage, two rolls of gauze, and some Celox as my 'compression KIT'. If you buy the components in bulk, it comes to a ridiculous savings over IB's. I feel the advantage of having a kit composed of an ace bandage, gauze and quick clot is that you don't have to use all the components if you don't need to. For example if you need to immobilize a wrist or ankle or shoulder use just the ace. If you need compression use the gauze in their rolled form under the ace. And you can decide if need to use the quick clot or not. If you need to 'pack' a wound or cover a 'road rash' scrape you can use the gauze, but gauze is also good for lots of other things than bleeding. I keep some compressed gauze also, because you can never have to much gauze.

These 'kit's' will compress down nicely when vacuum sealed so they don't take up more room than an IB if your worried about space.

Components:


YMMV

MAC MOD TCCC IFAK


Agree on all points. I opened up an Israeli 6" bandage to its full size and quickly realized that if you're putting one on a wound that large, you'd better have some first responders on the way. It will cover a wound, sure, but I'm not sure you could ever ratchet it down tight enough to make a long-term difference. The 4" is a lot more versatile. Maybe even two.

Mac, great idea to build your own kit! It gives you a lot more flexibility, it's lower cost, and much easier to restock. 

Crosscut

Quote from: Optimist on August 22, 2022, 05:58:31 PMAt first I was leaning towards only getting one to simplify training, but now I think I'm going to get at least one SWAT-T to experiment with. Mac makes a good point about it also being a pressure dressing. I've also read they can be handy for children or very small people who regular tourniquets are sometimes oversized for (I don't know if this is true, just something I've read a few times).

I do have some Israeli bandages, but having something multi-purpose is appealing.
SWAT-Ts here, and for that reason.  The probability of needing them for use on kids or dogs is at least as high, and probably greater, than on adults around our homestead I figure.  There's a significant number of tools, toys, and misc. devices that are anything but child-safe, and medium to large dogs meeting each other for the first time is pretty common here.

Had the Adventure Medical Trauma Paks on bi-monthly Subscribe and Save for a couple years, although the contents are a little different now and the cost is 25% higher than before.  Still would have been cheaper to build your own, but they are convenient and the packaging is pretty tough and waterproof.  Ran out of places to stash 'em so started giving them away before I finally cancelled the subscription.  Still keep one in each FAK, along with gauze dressings and rollers, and just recently added a 6" Israeli to each kit as well.

Crosscut

Quote from: Optimist on August 18, 2022, 07:16:31 PM(I was taught how to use a tourniquet in a first aid class, but I'd like to find a Stop the Bleed or similar class because that part of the first aid class I took felt a little rushed and inadequate.)

Free online Emergency Trauma Response Training Course.  I might take it this weekend since I'm stuck around the house for work anyway.

Optimist

Quote from: Crosscut on September 14, 2022, 06:22:36 AM
Quote from: Optimist on August 18, 2022, 07:16:31 PM(I was taught how to use a tourniquet in a first aid class, but I'd like to find a Stop the Bleed or similar class because that part of the first aid class I took felt a little rushed and inadequate.)

Free online Emergency Trauma Response Training Course.  I might take it this weekend since I'm stuck around the house for work anyway.
I'll have to check that out, as there is about an hour when I first get to my janitor job where I can't do much because people haven't started leaving the building. (Right now I've been tasked with learning a bunch of new nonsense, so it will probably be a week or two.)

I was wondering about the elasticity of the SWAT-T in the cold, as it might not be a good car kit option if it doesn't work well at subzero temps. Their website said they used them on an expedition to Antarctica, so I imagine they should be fine, although it would be nice if they gave actual testing temps.

Once my paycheck comes through I'm going to buy a couple of each.

Optimist

I still haven't bought any SWAT-T tourniquets. I got a buy one, get one half off deal on CAT tourniquets so I got a bunch of those. I gave away five of the CAT tourniquets to friends and family so now I'm back down to one CAT and a SOF-T that I got as part of a promotion on a first aid kit.

MacWa77ace

Remember; you have 4 limbs. I kinda keep 4 per person. 2 is 1 works for everything but TQ's.
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zXzGrifterzXz

I'm gonna apologize in advance since I was drinking an energy drink while writing this.

I have placed a number of tourniquets in the field as a Paramedic. Also as a SWAT medic I have had the opportunity to train with just about every variant currently on the market. With that said, previous posts were correct, "you'll be best with the one you train with."

However, not all tourniquets are created equally. If it's going to sit in a "truck kit" in a hot car for years you may want to avoid a plastic/polymer windless and go for a metal one instead. 

The current generation "SOF-T Wide" is in my opinion one of the best options in the market. Like if Glock made a tourniquet, it's caveman simple and very robust.


The newest generation CAT tourniquets are a very close second place. The CAT also get extra credit points for being able to be placed on your own upper extremity limb much more easily than others. Especially if you "train how you fight" and leave your affected limb limp during tourniquet application. 

The SWAT-T has failed independently run human occlusion tests numerous times. It's a pressure bandage adjunct at best. It does work well for our K9 though so I keep one in my K9 ifak to help care for my favorite "fur-missile"  teammates.  

So in my personal ifak on my swat body armor, I keep a SOF-T wide inside my ifak and a CAT strapped to the outside. 

Also, it bears mentioning that 90% of CATs on Amazon are fakes and will break/fail when you need them. Buy tourniquets from reputable vendors. 

But train, train, train. A lot of the major manufacturers make training tourniquets so you can practice. But the first time you apply a tourniquet from your kit onto a bleeding teammate or your spouse, or yourself, it shouldn't be the first time you've ever taken the thing out of the package. 
ZS Member since 2005.
NREMT-P / EMT-T
Hazmat Technician
1006 Rescue Technician

majorhavoc

Quote from: zXzGrifterzXz on May 31, 2023, 04:10:01 PMI'm gonna apologize in advance since I was drinking an energy drink while writing this.

I have placed a number of tourniquets in the field as a Paramedic. Also as a SWAT medic I have had the opportunity to train with just about every variant currently on the market. With that said, previous posts were correct, "you'll be best with the one you train with."

However, not all tourniquets are created equally. If it's going to sit in a "truck kit" in a hot car for years you may want to avoid a plastic/polymer windless and go for a metal one instead.

The current generation "SOF-T Wide" is in my opinion one of the best options in the market. Like if Glock made a tourniquet, it's caveman simple and very robust.


The newest generation CAT tourniquets are a very close second place. The CAT also get extra credit points for being able to be placed on your own upper extremity limb much more easily than others. Especially if you "train how you fight" and leave your affected limb limp during tourniquet application.

The SWAT-T has failed independently run human occlusion tests numerous times. It's a pressure bandage adjunct at best. It does work well for our K9 though so I keep one in my K9 ifak to help care for my favorite "fur-missile"  teammates. 

So in my personal ifak on my swat body armor, I keep a SOF-T wide inside my ifak and a CAT strapped to the outside.

Also, it bears mentioning that 90% of CATs on Amazon are fakes and will break/fail when you need them. Buy tourniquets from reputable vendors.

But train, train, train. A lot of the major manufacturers make training tourniquets so you can practice. But the first time you apply a tourniquet from your kit onto a bleeding teammate or your spouse, or yourself, it shouldn't be the first time you've ever taken the thing out of the package.
Wow.  Excellent point about a plastic windlass sitting in a hot car for multiple years.  
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MacWa77ace

I'm also concerned about the gloves and the nasal pharyngeal tube and the chest seals, have there been any tests for heat and age on them?

The 'plastic' windless is a polymer of fiber glass and plastics, I guess I'm running a test on the polymer windless right now and am about 3 years in on this one. I'm also running an ammo test in the same car that is about 8 years in.

I did a comparison of a well known brand vs a not well known brand CAT that probably doesn't go thru the certification testing, etc. And the only difference I could discern was that the nylon welds on the SZCTKlink were better/cleaner than the NAR TQ's. But this is not comparing a 'knock off' or 'counterfeit' to its original, its just brand vs brand IMO.

Right is NAR TQ, look at the welds on the nylon in the first pic.




I keep all my CATs set up [re-rigged] for quick deployment.
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zXzGrifterzXz


Quote from: MacWa77ace on June 01, 2023, 08:25:44 AMI'm also concerned about the gloves and the nasal pharyngeal tube and the chest seals, have there been any tests for heat and age on them?
Yes, all three do have "shelf lives" and do degrade over time. Usually NPAs are labeled as good for 3-4 years after they are produced, assuming that the package is intact. But I have found older NPAs in my own gear and on my ambulance(tucked in behind a box of supplies) than became stiff or brittle due to age and environmental exposure. Typically I have found that chest seals fair the best out of those three items as they are sealed in a packaging sleeve. But if the package has a tear in it I would discard /replace it or at least move that seal into a pile of training equipment.

QuoteI did a comparison of a well known brand vs a not well known brand CAT that probably doesn't go thru the certification testing, etc. And the only difference I could discern was that the nylon welds on the SZCTKlink were better/cleaner than the NAR TQ's. But this is not comparing a 'knock off' or 'counterfeit' to its original, its just brand vs brand IMO.
How many times did you have to turn the windlass to achieve occlusion and did the tourniquet start to become misshapen or deform during application? A properly tightly applied tourniquet should only allow for 2-3 turns of the windlass before total occlusion. Also it hurts the patient to apply them, like it hurts a lot. I've legitimately had people beg me to stop applying a tourniquet to their profusely bleeding lower extremity due to the pain of applying the tq. Be prepared to verbally coach your conscious patients through the application. "Hey man I'm really sorry about how much this is going to hurt but it will save your life."

A tourniquet may seem almost identical or even appear to be better made but the only way to know if it's  truly capable is to test it and see if it works. There are some great videos out there of people applying off-brand/knockoff tourniquets and showing how poorly they perform/fail to occlude/or downright break upon use. I wish I could find it at the moment but one of my instructors at CONTOMS made a video about fake TQs that is hysterical.

When it comes to equipment like this please buy quality gear from a reputable manufacturer. It's literally a life or death matter. 

Making sure you stage them is good and I agree with that 100% but I would also add make sure you can reach them with either hand if they are stored on your gear/kit. 
ZS Member since 2005.
NREMT-P / EMT-T
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MacWa77ace

#17
Good to know on the shelf life and environmental effects. Thanks.

Quote from: zXzGrifterzXz on June 01, 2023, 09:46:29 PMHow many times did you have to turn the windlass to achieve occlusion and did the tourniquet start to become misshapen or deform during application? A properly tightly applied tourniquet should only allow for 2-3 turns of the windlass before total occlusion. Also it hurts the patient to apply them, like it hurts a lot. I've legitimately had people beg me to stop applying a tourniquet to their profusely bleeding lower extremity due to the pain of applying the tq. Be prepared to verbally coach your conscious patients through the application. "Hey man I'm really sorry about how much this is going to hurt but it will save your life."

A tourniquet may seem almost identical or even appear to be better made but the only way to know if it's  truly capable is to test it and see if it works. There are some great videos out there of people applying off-brand/knockoff tourniquets and showing how poorly they perform/fail to occlude/or downright break upon use. I wish I could find it at the moment but one of my instructors at CONTOMS made a video about fake TQs that is hysterical.

When it comes to equipment like this please buy quality gear from a reputable manufacturer. It's literally a life or death matter.

Making sure you stage them is good and I agree with that 100% but I would also add make sure you can reach them with either hand if they are stored on your gear/kit.


They were probably about same number of turns. I wasn't really testing that. 2-3 3-4 +. There are variations based on muscle tone, clothing, location, proper application of the strap etc. And I'd expect that there would be variations within a 'lot' [bought in the same batch] of the same manufactured TQ's. So turn count is an iffy, real world, ranking system. To scientifically test that you'd have to put it on an inflexible pipe of a set size. I didn't bother. It didn't take 10 - 20 turns. They were in the expected range. You can sort of tell if there's going to be a turn issue can't you? If that strap that the windless is attached to is too slack to start.

What I did test was the strength of the windless by hanging a weight off it at 90 degrees. I didn't test it to breakage, only what I thought was a reasonable amount of torque on 50% of the windless.

And then another test was to hang a larger weight off the windless that was supported by the strap to test the nylon strap strength. The strap itself breaking was another concern of mine.

I've heard all the counterfeit stories and seen video's also. that's the only reason why I tested these alternate brand TQ's when I got them.

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Uomo Senza Nome

#18
With the growing popularity of mass shootings, I've taken a two prong approach. I have higher end better SOF-T wide for my personal kit and 10 of these for some type of mass casualty event that I might be unfortunate enough to be at.

https://www.temu.com/medical-set-cat-tactical-combat-tourniquet-molle-system-medical-kit-small-tactical-emt-medical-scissors-g-601099512817277.html

For $7@ you get clothing sheers and a CAT in a tidy package (note price changes frequently, I've seen as cheap as $4). Not the best true, but in times of urgent need might be a lifesaver. These types of events might have a really long time between wound and any type of medical care so something is literally better than nothing. Also light enough to go into a lightweight carry kit.



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