troglodyte wrote: Wed Jul 17, 2019 12:58 pm
ACTIVE SHOOTER: A TOURNIQUET WON’T SAVE YOU?
https://www.tierthreetactical.com/activ ... -save-you/
“-Overall, 58% of victims had gunshots to the head and chest, and only 20% had extremity wounds. The probable site of fatal wounding was the head or chest in 77% of cases. Only 7% of victims had potentially survivable wounds. The most common site of potentially survivable injury was the chest (89%). No head injury was potentially survivable. There were no deaths due to exsanguination from an extremity. “
A really good read.
I still, and I think the author would also, applaud the move to educate more people in STB. The numbers in the article may vary a little depending on what source you get them from but I think it generally holds true that a TQ is not going to be the life-saving talisman that we want to believe it is in an active shooter situation. In Boston-bombing type events, natural disasters, workplace accidents, and vehicle accidents they will probably play a much larger role. Will I still carry my TQ and have it available in several kits? You bet! As a matter of fact, I just received an order from Rescue Essentials containing several items including another TQ.
TQs are just a piece of the "being prepared" puzzle and they are easy to use and stow away. I contend that Situational Awareness is the number one skill to have and develop. Everything else is just for when Murphy shows up. I think it is great that STB will be taught in schools.
This isn't the first time I've seen the studies the author cites, & they seem to be spot on. The nature of active shooter events has many similarities with combat injuries, however the percentages / types of injuries differ. (Soldiers typically wear helmets & body armor, so the # of chest injuries are reduced, whereas blast & extremity injuries are prevalent. Wounding patterns of civilian victims of active killers differ depending on mechanism of injuries (GSW, blast from IEDs, vehicles driving into crowds).
The key phrase that I'd like to highlight is "potentially survivable injuries". Instead of dwelling on the #'s of deaths that were NOT survivable (which I think the links author used as an attention grabber), let's focus on what can be done with those that are potentially survivable. Not much can typically be done for a GSW to the head at point blank range, especially if the victim has submitted & is not fighting back. From what I see in the bill Gov Abbott signed, the training & equipment list covers what is appropriate. (Equipment list includes TQs, pressure bandages, chest seals, & space blankets, among other things).
For the potentially survivable chest injuries (not involving major vascular damage, as in didn't hit the heart or aortas):
- We can apply a chest seal (commercial, or anything plastic that can prevent air from entering the chest cavity). If there's a puncture wound anywhere from the collar bone down to the belly button, slap a chest seal on it. (Check for entrance & exit wounds; exit wounds will likely be larger). This patient should have priority for evacuation if there's limited assets in a mass casualty event (a chest seal only prevents the air from sucking in from the outside; pressure can still build up if there's a hole in the lung leaking air into the chest cavity from the inside).
- If they must be left behind, roll them onto their side in the Rescue Position (preferably onto their injured side, so that their uninjured lung is up). This helps keep the airway open.
- For junctional areas of the torso (arm pits; shoulders, crease where the groin meets the legs), we can use wound packing (commercial gauze w/ or w/o hemostatic agents, or any cloth that can be packed into the wound to press against the bleeding vessel), topped off with a pressure dressing. Remember it's not just shoving material into the wound; you need to get deep enough to actually press up against the bleeding vessel, then pack to fill the wound so that the pressure dressing maintains that pressure.
For the extremities, TQs are still the best option. They go at least 3-4" above the injury (NEVER on a joint, so 3-4"above the joint if injury is at/near the joint), & as tight as possible until there's no longer a pulse below the TQ. If you don't have the luxury of time, just put the TQ as high as possible on the extremity. If one TQ doesn't stop the bleeding, place a second one just above it.
When done with the primary treatment (s), wrapping the casualty in a space blanket or something else to prevent hypothermia will enhance survival rates (blood loss leads to hypothermia, & hypothermia inhibits the clotting process, which leads to more bleeding).
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