Thread: TQ Protocols
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Old 04-24-2006, 18:13   #4
Cincinnatus
Guerrilla
 
Join Date: Mar 2005
Location: Vermont
Posts: 342
Quote:
Originally Posted by Eagle5US
Dude...

Your post is all over the place. Are you making statements or asking questions?
Stopping bleeding is currently number one priority on the battlefield to allow soldiers to continue the fight until evacuation is appropriate. As such...it is the battlefield.
EMS is a whole different ballgame. Can't compare the two...goverend by two sets of rules and standards.

Focus your post and try again...

Eagle

Eagle,

Sorry, if I was less than clear. "Stopping bleeding is currently number one priority on the battlefield..." Should applying a TQ, again assuming serious injury to an extremity, be the default for stopping bleeding? From what I've read this is being debated, with some favoring TQs as first response, others advocating direct pressure.

Off the top of my head, I can think of five categories of traumatic injury where applying a TQ might be advised.

1) On the battlefield - "care under fire"

2) In the civilian equivalent

3) EMS responding to scene

4) Individual at scene

5) Backcountry or Katrina type situation, where EMS is unlikely to help any time soon

In which of the above should applying a TQ be the default first response?

1) and 2) it would seem that it should be, driven by "tactical" considerations.

3) arguably not as both protocols probably dictate otherwise and other options are immediately available, but perhaps in the case of mass trauma (e.g., bus or train wreck or terrorist attack) driven by number of Px and limited resources

4) as I was taught, direct pressure should be first course of action, but I'm wondering if TQ isn't every bit as valid (assuming decent TQ, using a shoe string would be likely to cause problems)

5) I'm uncertain. In all the above, it would not be unreasonable to assume that the Px will be in a hospital setting before concerns over lack of blood flow to the extremity are likely to cause problems, bleeding can be controlled by other methods, etc. However, in the back country or any situation where the Px is hours away from hospital care the issue becomes more complex, but I wonder if using the TQ to control bleeding first isn't still a good option.

That any better/ clearer?

I guess there are a couple of other questions in there as well. What are the risks in TQ use? Any besides those already noted? How should they be mitigated against or dealt with? In instances where it's reasonable to expect that the Px will be under hospital care w/in an hour, so that the risk of tissue damaged because of inadequate perfusion is minimal, is there any reason not to apply the TQ a bicep or thigh, where it is easier to restrict blood flow, than closer to a wound to the forearm/ hand or calf/ foot?
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