Lucky to survive

[Tele 'til You're Smelly]

Thought so. Is it as brushy as Madden Creek?

no look at the pics- way more open- and dangerous!

[adrenalated]

Bet you have one or two Voile straps.

Two things:
1) it's MUCH easier to get a CAT as tight as it needs to be to work effectively than a Voile strap.
2) the wider strap of a CAT is much less likely to cause permanent tissue damage especially considering it will likely be a minimum of several hours to definitive medical care in a backcountry setting

Carry the real thing.

[old goat]

Bet you have one or two Voile straps.

Good luck occluding a femoral artery with Voile straps. More likely you'll block the venous outflow without stopping arterial inflow, increasing the bleeding.

[whipski]

"All bleeding eventually stops." Rosen's Rules of Trauma

why is my foo turning blue?

[summit]

Your effort is applauded, but venous pooling turns things blue and does nothing to prove the artery is blocked. Did your palpable pulses go away? Personally until you experiment has nothing on doppler of your popliteal, I am unconvinced.

It might be possible with a voile, sure... hell you might be able to do it with 550 cord, but that is an extremely suboptimal plan too and might be more painful than the injury. Sufficiently applied voile strap tq is going to hurt like a lot in very short order.

I've seen people bleed out from crapy/crappily applied tourniquets.

[adrenalated]

Not really sure why you're so committed to using the wrong tool for the job, whipski. Would I attempt a Voile strap tourniquet if I had no other options and the patient was probably going to die if I didn't try? Of course. But for $30 and 3oz and negligible pack space I'd rather just carry the real thing.

[old goat]

Like Summit said. If you had stopped the arterial inflow your foot would be white, not blue.
If you don't have a proper tourniquet at least use something that isn't elastic. A pack strap maybe. Preferably from the victim's pack. A belt is traditional. So not Arcade. (A tourniquet isn't something that would be high on my list of things to put in a first aid kit, but the subject has been discussed ad nauseam a few times in the PR and ski forums.)

[whipski]

That was my original point you use the tools you have. The stretch of the strap is not infinite. I'm convinced a couple more turns on the strap would occlude the artery. You could snap this on in seconds and not watch your friend bleed out while you fuck around looking for a knife to cut pack straps. However I would never fault you for carrying tourniquets. I've often thought about carrying a couple cravats (triangular bandages). You can make an ankle harness over a ski boot in seconds and and link the straps of adjustable ski poles for a make shift hare traction. Cravats were used for tourniquets in the military and its always useful to sling and swath a shoulder injury. Thread drift?

[old goat]

I'm sorry, but I'm going to have to insist on seeing a picture of your dead white foot before I believe you.

[MagnificentUnicorn]

Good luck occluding a femoral artery with Voile straps. More likely you'll block the venous outflow without stopping arterial inflow, increasing the bleeding.

Venous tourniquet, the bane of our existence with fat people.


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[MagnificentUnicorn]

Your effort is applauded, but venous pooling turns things blue and does nothing to prove the artery is blocked. Did your palpable pulses go away? Personally until you experiment has nothing on doppler of your popliteal, I am unconvinced.

It might be possible with a voile, sure... hell you might be able to do it with 550 cord, but that is an extremely suboptimal plan too and might be more painful than the injury. Sufficiently applied voile strap tq is going to hurt like a lot in very short order.

I've seen people bleed out from crapy/crappily applied tourniquets.

A voile strap or paracord might stop the bleeding but you’ll lose your leg.


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[summit]

A voile strap or paracord might stop the bleeding but you’ll lose your leg.


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Falls under extremely suboptimal

[goldenboy]

I took my WFR in the late 90's. At the time they had were pretty much going with "tourniquets bad, don't use them". Interesting how that one has turned around. And to bring it back around to the topic of the original post, it seems to have helped this guy and he seems like a cool dude, so I'm glad it did.

[adrenalated]

I took my WFR in the late 90's. At the time they had were pretty much going with "tourniquets bad, don't use them". Interesting how that one has turned around.

The Iraq War happened and we learnt stuff. Good example of why doing the recert is worthwhile

[whipski]

I'm sorry, but I'm going to have to insist on seeing a picture of your dead white foot before I believe you.

You're cute! If the strap was effective why would my foot be dead? Life over limb I guess. Anyway more to the point. Guess I'll put this in the pack next to the avi-lung.
http://www.combattourniquet.com/

[summit]

You're cute! If the strap was effective why would my foot be dead? Life over limb I guess. Anyway more to the point. Guess I'll put this in the pack next to the avi-lung.
http://www.combattourniquet.com/

CAT is a great choice, easy/reliable to apply, and is light. You're in Salida so I'd say swing by Rescue Essentials, but they moved to bigger digs. Know that if you ebay it, there are knockoffs.

To answer your question, a tourniquet used properly at the right time saves your life by stopping you from bleeding out. A GOOD tourniquet does that without destroying the tissue underneath it.. If you destroy the tissue circumferentially around your leg by crushing the structures and cells with a narrow tourniquet, that means you end up losing everything distal. I defer to old goat as it becomes a surgical problem at that point.

[goldenboy]

The Iraq War happened and we learnt stuff. Good example of why doing the recert is worthwhile

So the moral of the story is that war is good? j/k.

I did a shorter WFA a few years back at least. I'm kind of the opinion that you can deal with minor things like a blister in the field, but pretty quickly it ramps up to needing care in a medical setting- especially if all you do is a class with no practice, it's different if you work in a hospital like Summit etc. But you're just not going to do a field tracheotomy with a leatherman and a straw and assemble a rescue sled and get your buddy to the hospital, you just aren't... So better to have some extra layers and an inreach than anything else, imo.

[MagnificentUnicorn]

So the moral of the story is that war is good? j/k.

I did a shorter WFA a few years back at least. I'm kind of the opinion that you can deal with minor things like a blister in the field, but pretty quickly it ramps up to needing care in a medical setting- especially if all you do is a class with no practice, it's different if you work in a hospital like Summit etc. But you're just not going to do a field tracheotomy with a leatherman and a straw and assemble a rescue sled and get your buddy to the hospital, you just aren't... So better to have some extra layers and an inreach than anything else, imo.

I had this conversation with a touring partner the other day. He had his first aid kit which is good. But really it’s good for minor cut, scrapes and blisters etc. A tourniquet is a good idea but so is a splint of some kind, and a rescue sled. What about pain killers, stronger narcotics? The reality is that unless you’re practiced with these treatments regularly it’s not really practical. Get a tourniquet, a real one, if you must it’ll save a life or limb. Having insulation, a means for fire, water and some food, some sort of way to contact EMS/S&R are probably the most practical things you can carry.


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[old goat]

You're cute! If the strap was effective why would my foot be dead? Life over limb I guess. Anyway more to the point. Guess I'll put this in the pack next to the avi-lung.
http://www.combattourniquet.com/

Well your foot would only be dead while the tourniquet was on. Just don't leave it too long.

I took my WFR in the late 90's. At the time they had were pretty much going with "tourniquets bad, don't use them". Interesting how that one has turned around. And to bring it back around to the topic of the original post, it seems to have helped this guy and he seems like a cool dude, so I'm glad it did.

Tourniquets are bad because lack of blood supply and the direct pressure of the tourniquet damages tissue. Tourniquets are good because they can keep people from bleeding to death. Things go back and forth. Iraq, with a lot of extremity wounds from IED's, showed the value of tourniquets, as used for severe injuries and applied by trained medics. My guess is that the use of tourniquets in civilian life, applied by people with little or no training, for wounds that have less than life threatening bleeding, will do more harm than good and the pendulum will swing back again. Given the speed of transport in urban settings, most unnecessary or improperly applied tourniquets will be removed before any harm is done. That might not be the case in rural and especially backcountry situations. Time will tell.

So the moral of the story is that war is good? j/k.

I did a shorter WFA a few years back at least. I'm kind of the opinion that you can deal with minor things like a blister in the field, but pretty quickly it ramps up to needing care in a medical setting- especially if all you do is a class with no practice, it's different if you work in a hospital like Summit etc. But you're just not going to do a field tracheotomy with a leatherman and a straw and assemble a rescue sled and get your buddy to the hospital, you just aren't... So better to have some extra layers and an inreach than anything else, imo.

I've been told in all seriousness, by a famous surgeon, that the medical advances developed in war time have saved more civilian lives in peacetime than have been lost in the wars. This is obviously absurd. You may have been kidding, but he wasn't.

I like your second paragraph too. I would add that even in the hands of well trained surgeons, rarely done procedures to deal with extreme emergencies don't go nearly as well as the books say. Finger control of the innominate artery eroded by a tracheostomy, cricothryoidotomy for gun shot wound to the face, inferior vena cava shunt for gunshot wound to the IVC--I have experience with all of these and they don't usually work as advertised. And I'm used to the sight of blood. To paraphrase Mike Tyson--everyone has a plan until the blood hits them in the face.

[adrenalated]

Yeah, you're not wrong GB. A big takeaway from my WFR was definitely that a reliable way to get professional help coming ASAP is probably the most valuable thing you can carry in the backcountry. I learned a LOT of skills that could potentially be useful and save a life but realistically it was all stuff to just buy slightly more time. The end result is you still have to evacuate pretty much everything that you'd expect you might need to evacuate, and the sooner the better.

Most of what's in my first aid kit is really just cuts and scrapes and blisters stuff, like others have said.

[Meadow Skipper]

…Finger control of the innominate artery eroded by a tracheostomy, cricothryoidotomy for gun shot wound to the face, inferior vena cava shunt for gunshot wound to the IVC--I have experience with all of these and they don't usually work as advertised. And I'm used to the sight of blood. To paraphrase Mike Tyson--everyone has a plan until the blood hits them in the face.

That’s quite the list of Bad Things Happening. Remind me not to go touring with OG. Seems like he runs into trouble.

[muted reborn]

I took my WFR in the late 90's. At the time they had were pretty much going with "tourniquets bad, don't use them". Interesting how that one has turned around. And to bring it back around to the topic of the original post, it seems to have helped this guy and he seems like a cool dude, so I'm glad it did.

From a WFA book called Wilderness Life Support for a WFA class I'm taking this Friday - says tourniquets are "widely viewed as last resort only"

[old goat]

Yeah, you're not wrong GB. A big takeaway from my WFR was definitely that a reliable way to get professional help coming ASAP is probably the most valuable thing you can carry in the backcountry. I learned a LOT of skills that could potentially be useful and save a life but realistically it was all stuff to just buy slightly more time. The end result is you still have to evacuate pretty much everything that you'd expect you might need to evacuate, and the sooner the better.

Most of what's in my first aid kit is really just cuts and scrapes and blisters stuff, like others have said.

I've babbled about this ad nauseum in other forums but I'm a big fan of a roll of 2 inch athletic tape (and a razor if you're not a sadist)--won't help much for skiing but for hiking it can convert a sprained ankle from an evacuation to a slow walk out. If you know how to tape an ankle. I learned this personally--not in the BC--but I sprained my ankle badly playing basketball, multiple ligaments with little chip fractures. I went to the ortho clinic at the VA I was working at to get a cast put on so I could work and the old school tech taped me up instead. Amazing how well it worked.

[joetron]

Mint rode his bike across town to watch the slalom races last…good to see him out in the world.


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