Combat Application Tourniquet C A T

Report
COMBAT APPLICATION TOURNIQUET
CAT
MSA Training Weekend
Saturday 18th Sunday 19th January 2014
Royal Lancaster Infirmary
Education Centre
Presented
By
Paramedic Mr Dave Stubbs
OBJECTIVES
• Update of forthcoming MSA Blue Book medical
equipment list for 2014 – 15
• To understand the importance of haemorrage control
• To have an understanding of C A T tourniquets
• To have practical use & application of a C A T
tourniquet
BRIEF HISTORY OF TOURNIQUETS
• Introduced by the ancient greeks to the romans
• First reported use in 1674 during Siege of Besancon in
eastern france
(Laffin 1999)
• Used in american civil war 1861 – 1865
• Used in conflicts & medicine to date
• Currently used by the military, uk ambulance services &
police forces
CATASTROPHIC HAEMORRAGE
• Uncontrolled haemorrage commonest cause of
preventable death in trauma patients
( Hollcomb et al ann surg 2008)
• Priority changed from A B C – C A B C military
treatment < C > A B C Catastrophic bleeding 1st
• Catastrophic haemorrage should be arrested 1st
• Secondly airway, breathing & then back to circulation
• The idea is to prevent exsanguination & death while
airway is being assessed & maintained
CAUSES OF HAEMORRAGE
Many mechanisms
• Blunt trauma, causing internal haemorrage ie: pelvic
injuries organ lacerations less obvious in some cases
• Penetrating Trauma, to the head, neck, torso & limbs
COMBAT APPLICATION TOURNIQUET
TO TOURNIQUET OR NOT TO TOURNIQUET ?
THAT IS THE QUESTION !
THAT IS THE QUESTION !
THAT IS THE QUESTION !
SOME TRAUMATIC GRAPHIC IMAGES NOW
FOLLOW
TOURNIQUET REQUIRED ?
BI LATERAL C A T TOURNIQUETS IN USE
TOURNIQUET IN USE
BOSTON MARATHON BOMBING IMPROVISED
TOURNIQUET IN USE
SUMMARY
• Catastrophic serious haemorrage is a leading cause of
death in major trauma & rapid attempts must be made
to control bleeding 1st < C A B C >
• Motorsport Doctors & Paramedics may have further
interventions to combat major haemorrage such as
Celox Gauze, Olaes & Blast Dressings, & Tranexamic
Acid (TXA)
THANK YOU
ANY QUESTIONS ?
REFERENCES
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Emergency Nurse June 2010 Vol 18
Emergency Nurse November 2013 Vol 21
Google Images
JRCALC 2013
Motor Sports Association 2014 Yearbook
NWAS NHS Trust Pre Hospital Trauma Care Training 2013
PHTLS Manual 7th Edition 2011
PHTLS Manual Military 7th Edition 2011
Zipp Photography Richard Danby 2013

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