Thank you for your great info. I am wilderness first aid trained and a trainer. Definitely checking circulation is critical to make sure it is tight enough.
Wish I could like this a bunch of times. I'm a total novice when it comes to first aid. This is an awesome video. Seeing other emergency responders saying the same is fantastic. Thank you for mentioning the snake bite bit. That much I do know thanks to Wes Larson of Tooth and Claw podcast. You got a new subscriber!
I have been a first aider at work for almost 40 years, with regular training once a year. In the past, we were trained on how to use a tourniquet, but not anymore. Too many people got it wrong. Now, we are strongly discouraged from using one. I am glad you made this video warning against the most common mistakes.
I’ve heard that about some first aid trainings in recent years! It’s definitely easy to get it wrong, especially when you’re freaking out, like any good human. I’ve even seen it taught wrong, which is frightening!! But it’s easy to see how people could inadvertently make a situation worse.
Thank you! I REALLY want to do the NOLS WFR course when I have the time and money, but there are other good ones out there as well. I know people have said they didn’t get as much hands-on with NOLS, I think partly because of their focus on leadership. The company making the dangerous recommendations I mentioned in the video also offers WFR, so be sure to vet any companies thoroughly, and go for one that only does hands-on (also a red flag if they’re willing to certify you without anything in-person!!). I hope that helps!
My girlfriend went to training, and learned to tighten a tourniquet beyond what seems reasonable. I bought two tourniquets of my own, and tried one on my arm. Before tightening it I could feel my radial pulse just fine. I tightened the tourniquet until I could no longer feel any radial pulse. That's all we need to do, right? It doesn't seem to me that there would be any reason to tighten the tourniquet more than that. Am I right, or is she?
My experience is that a palpable pulse disappears at around 10-15 mmHg. It isn't much, but it is still moving a lot of blood, especially if the patient is a bit tachy. She is recommending to tighten until the bleeding stops, completely. That can take a lot of pressure, so the trainers are trained to just go very tight. I was trained by a trauma surgeon to use 3 types of TQ. A lymphatic , a ball type (or arterial specific), and a strap TQ, like this one. It was nice to have the training, but I am not a surgeon, and I don't trust my ability to accurately choose. I go with a tight strap if I feel I have to go at all. A TQ is a last resort tool.
You shouldn't feel a pulse, but ultimately, you need to tighten until the bleeding has stopped completely, and it may feel tighter than seems reasonable, but the goal is to keep someone from bleeding out.
Thank you. I looked for a video like this previously while preparing for a hunting trip into the wilderness. 2 tourniquets, Unpackaged, on your person, Great advice. Can you recommend a wilderness/gun shot first aid kit?
Thank you so much, Brett! In addition to a standard backpacking FAK (I show mine here: th-cam.com/video/p0txKoDtwSI/w-d-xo.htmlsi=RYZ8qfoNTl7oUkls ), for hunting, I'd carry 1-2 Israeli bandages and some 4x4 gauze (not individually packed, but get a pack of it and store it in a Ziplock so you can grab several at a time to put pressure on a large bleed). I have this Israeli bandage amzn.to/3NOs4Fr . QuikClot gauze would also be wise, and I keep it in my backpacking FAK amzn.to/3NOs4Fr . I would put it on first, then put the 4x4 gauze on and apply a lot of pressure to something like a gunshot wound or wound from bow hunting. You can use a bandana, Israeli bandage or something else to keep the gauze on once the bleeding has stopped. I'm in the process of updating my FAK video, because I am now carrying that Israeli bandage and the two tourniquets, and I want to show other updates I've made.
That was very well done. Thanks. But in my four decades of committed hiking and backpacking, most always solo, I've never once had any type of situation where a tourniquet would be applicable. For myself or anyone else I've run across. So I think just as important as knowing how to use one is to learn how to not need one in the first place. And if any new hikers respond with "But what about an animal attack" my head might explode, and I'll need a tourniquet, so please don't. :)
I hope no one watching (or not watching!) ever needs to use this skill, but unfortunately, freak accidents happen, even to cautious hikers. Boulders fall, branches break, trees fall, people trip onto objects, etc. I agree that the circumstances are rare, but I would say more likely than a genuinely dangerous animal encounter (provided you know what to do if you see an animal). I also agree that prevention is the best medicine, which is one of the missions of my channel. I’m all about enjoying the outdoors safely and responsibly. 🙂
@@WanderingSwitchback I hear you. But out of curiosity, have you ever been in the wilderness around active boulder falls, tree falls nearby, tripping in a way that would require a tourniquet? I'm not slamming you. Your intentions are clearly good and you know what you're talking about. That was solid information. But I'm a little sensitive to fear in the wilderness. People lap it up and it's unfounded. Respect and fear are different things. Fear keeps people out. Respect brings people in. Even though I live in a safe, tiny village in the mountains I know that I'm never safer than when I'm alone in the wilderness. So my comment wasn't personal. It was more about how the uninitiated perceive things. Thanks and Happy Trails.
Fear-mongering is rampant in the hiking community (especially from outside!)- about women going out solo, anyone solo hiking, going into bear country, etc.- and I share in your frustration with that. I understand that some WFA courses are no longer teaching tourniquet use because of the dangers and misuse. In fact, the dangers of misuse of a tourniquet can be higher than the lack of use of a tourniquet, so take from it all what you will. I have not personally been in the wilderness in a situation that has required a tourniquet, and I certainly hope I never am. I have also not required the use of my SOS button, but I carry it on my person, even while I'm using a cat hole. I have, though, been out in the wilderness when a rock slide has occurred, when avalanches have happened, trees have fallen (I actually have a video where a huge tree fell near me in the middle of me recording!) and have experienced a gnarly fall that could have necessitated SAR under different circumstances. Even the most cautious among us can be humbled by Mother Nature at times. There is NO mitigating for every risk, and as you likely know, the risks of injury are higher driving to a trailhead than actually being on the trail. Everyone gets to decide for themselves what gear they will carry (some people don't even carry Bandaids!). I appreciate a devil's advocate and questioning the rationale of something that may feel extraneous or fear-based, and certainly don't take it personally. Happy hiking! ETA: here's that video with the tree falling! th-cam.com/video/BYNbgFDSXSw/w-d-xo.html
@@WanderingSwitchback Great timing with that tree fall! Awesome. I've heard a couple at a distance and it's pretty trippy. That's why looking for widowmakers is a must do before setting up. A million to one shot though. And I appreciate you mentioning the fear component. It's just something that really gets to me. I'm not a fan. Especially when all it takes is a little education, humility and respect to move it out. But I've learned that some just gravitate towards fear. And that's fine. For them. But don't impose or expect it from others. Single women backpacking? Go for it. The farther you are from a popular trailhead the safer it is. And when you're out there nobody cares about your gender, race, fitness or any of it. At least I know I don't and I'm not alone. I live at 7K in a forest and am usually out five or six days a week. The ONLY thing that's ever got my shorts tight is wildfires. And I've been near a couple that have ignited while I've been out there. But that's something totally random. Otherwise, I don't think it takes much to stay safe. My mantra is "what if?" Works for me to keep me out of sketchy situations. It's just a matter of stopping and thinking. Rock, snow, water, weather, people. Covers it all. :)
Nice job. The other risk of removing a TQ is profound shock and cardiac arrest from the sudden drop in blood pressure. Resolvable in a clinical setting, but not so much during transport. BTW, I commented to another below, but I would like your take; I had to do a lot of palpable blood pressure in noisy ambulances. I can't feel a BP under 15 mmHg, so I had readings like " 60 / palp " of such. Can you actually feel very low PB using a distal pulse?
Excellent point about the sudden drop in BP! Distal pulses would be a less than ideal place to try to palpate if a patient has low BP. Like you stated, 60/palp is what I have seen as well (we had one come in like that the other day- didn't make it). I could feel his femoral and carotid pulses (and his A/V pacemaker when he was pulseless), but not his radial pulse. Sometimes, the DBP is just too low to really identify. The lowest I saw documented on this guy from the Phillips was something like 40/28, but I can't imagine finding that manually, even in a quiet setting.
This is so important! I’m hoping to get an emergency first aid wilderness course this year. Thanks for clearing up the nonsense. I saw a first aid kit on amazo that had a rubber strap like the ones for giving blood listed as a tourniquet and was like whaaa? Maybe if I need an extra gear lash or water hang this would be useful….
You can certainly TRY it if you don't have anything else, but you won't get enough pressure without a windlass for a true arterial bleed, especially with how stretchy a shirt is, and a belt is too stiff for a windlass. I would not want to rely on this when it comes to saving a life. The few extra ounces for a good tourniquet is worth it.
Thank you for this. As always, your videos are well done and include very valuable information. Please keep creating videos on these type of subjects.
Thank you so much, Ken!
Bravo!!! Just subscribed.
Bless you.
Thank you! Welcome aboard!
Thank you for your great info. I am wilderness first aid trained and a trainer. Definitely checking circulation is critical to make sure it is tight enough.
For sure!
TH-cam recommended me this at 16 views.
Sometimes the algorithm is actually good it seems.
Great video
I appreciate that! Welcome! 🤗
Great job on the video it answered all my questions! “Shouldn’t be applied to the head or trunk” 😂😂😂
Haha, one can never assume people will know! I'm glad this answered your questions! 😊
Thank you for the tourniquet video. Good information and an awesome demonstration of applying the tourniquet.
Thank you so much!
Wish I could like this a bunch of times. I'm a total novice when it comes to first aid. This is an awesome video. Seeing other emergency responders saying the same is fantastic. Thank you for mentioning the snake bite bit. That much I do know thanks to Wes Larson of Tooth and Claw podcast. You got a new subscriber!
Thank you so much! Welcome!
Had no idea there was a wrong way. Thank you for the video!
I think people can be scared to hurt someone by not going tight enough. Not to mention people using them when they aren't indicated! Happy to help! 🙂
Great information. Thanks for sharing and merry christmas 🎄
Thank you so much! Merry Christmas to you as well!
I have been a first aider at work for almost 40 years, with regular training once a year. In the past, we were trained on how to use a tourniquet, but not anymore. Too many people got it wrong. Now, we are strongly discouraged from using one. I am glad you made this video warning against the most common mistakes.
I’ve heard that about some first aid trainings in recent years! It’s definitely easy to get it wrong, especially when you’re freaking out, like any good human. I’ve even seen it taught wrong, which is frightening!! But it’s easy to see how people could inadvertently make a situation worse.
Thank you very much for a very informative video. I learned alot from it.
Thank you so much!
Great information switchback.
Thank you! 😊
Thank you for this informative information!
Thank you!
Great information! Love your channel! What wilderness first responder class do you recommend for fellow nurses??
Thank you! I REALLY want to do the NOLS WFR course when I have the time and money, but there are other good ones out there as well. I know people have said they didn’t get as much hands-on with NOLS, I think partly because of their focus on leadership. The company making the dangerous recommendations I mentioned in the video also offers WFR, so be sure to vet any companies thoroughly, and go for one that only does hands-on (also a red flag if they’re willing to certify you without anything in-person!!). I hope that helps!
My girlfriend went to training, and learned to tighten a tourniquet beyond what seems reasonable. I bought two tourniquets of my own, and tried one on my arm. Before tightening it I could feel my radial pulse just fine. I tightened the tourniquet until I could no longer feel any radial pulse. That's all we need to do, right? It doesn't seem to me that there would be any reason to tighten the tourniquet more than that. Am I right, or is she?
My experience is that a palpable pulse disappears at around 10-15 mmHg. It isn't much, but it is still moving a lot of blood, especially if the patient is a bit tachy. She is recommending to tighten until the bleeding stops, completely. That can take a lot of pressure, so the trainers are trained to just go very tight. I was trained by a trauma surgeon to use 3 types of TQ. A lymphatic , a ball type (or arterial specific), and a strap TQ, like this one. It was nice to have the training, but I am not a surgeon, and I don't trust my ability to accurately choose. I go with a tight strap if I feel I have to go at all. A TQ is a last resort tool.
You shouldn't feel a pulse, but ultimately, you need to tighten until the bleeding has stopped completely, and it may feel tighter than seems reasonable, but the goal is to keep someone from bleeding out.
Thank you. I looked for a video like this previously while preparing for a hunting trip into the wilderness. 2 tourniquets, Unpackaged, on your person, Great advice. Can you recommend a wilderness/gun shot first aid kit?
Thank you so much, Brett! In addition to a standard backpacking FAK (I show mine here: th-cam.com/video/p0txKoDtwSI/w-d-xo.htmlsi=RYZ8qfoNTl7oUkls ), for hunting, I'd carry 1-2 Israeli bandages and some 4x4 gauze (not individually packed, but get a pack of it and store it in a Ziplock so you can grab several at a time to put pressure on a large bleed). I have this Israeli bandage amzn.to/3NOs4Fr . QuikClot gauze would also be wise, and I keep it in my backpacking FAK amzn.to/3NOs4Fr . I would put it on first, then put the 4x4 gauze on and apply a lot of pressure to something like a gunshot wound or wound from bow hunting. You can use a bandana, Israeli bandage or something else to keep the gauze on once the bleeding has stopped.
I'm in the process of updating my FAK video, because I am now carrying that Israeli bandage and the two tourniquets, and I want to show other updates I've made.
That was very well done. Thanks. But in my four decades of committed hiking and backpacking, most always solo, I've never once had any type of situation where a tourniquet would be applicable. For myself or anyone else I've run across. So I think just as important as knowing how to use one is to learn how to not need one in the first place. And if any new hikers respond with "But what about an animal attack" my head might explode, and I'll need a tourniquet, so please don't. :)
I hope no one watching (or not watching!) ever needs to use this skill, but unfortunately, freak accidents happen, even to cautious hikers. Boulders fall, branches break, trees fall, people trip onto objects, etc. I agree that the circumstances are rare, but I would say more likely than a genuinely dangerous animal encounter (provided you know what to do if you see an animal). I also agree that prevention is the best medicine, which is one of the missions of my channel. I’m all about enjoying the outdoors safely and responsibly. 🙂
@@WanderingSwitchback I hear you. But out of curiosity, have you ever been in the wilderness around active boulder falls, tree falls nearby, tripping in a way that would require a tourniquet?
I'm not slamming you. Your intentions are clearly good and you know what you're talking about. That was solid information. But I'm a little sensitive to fear in the wilderness. People lap it up and it's unfounded. Respect and fear are different things. Fear keeps people out. Respect brings people in. Even though I live in a safe, tiny village in the mountains I know that I'm never safer than when I'm alone in the wilderness. So my comment wasn't personal. It was more about how the uninitiated perceive things. Thanks and Happy Trails.
Fear-mongering is rampant in the hiking community (especially from outside!)- about women going out solo, anyone solo hiking, going into bear country, etc.- and I share in your frustration with that. I understand that some WFA courses are no longer teaching tourniquet use because of the dangers and misuse. In fact, the dangers of misuse of a tourniquet can be higher than the lack of use of a tourniquet, so take from it all what you will.
I have not personally been in the wilderness in a situation that has required a tourniquet, and I certainly hope I never am. I have also not required the use of my SOS button, but I carry it on my person, even while I'm using a cat hole. I have, though, been out in the wilderness when a rock slide has occurred, when avalanches have happened, trees have fallen (I actually have a video where a huge tree fell near me in the middle of me recording!) and have experienced a gnarly fall that could have necessitated SAR under different circumstances. Even the most cautious among us can be humbled by Mother Nature at times.
There is NO mitigating for every risk, and as you likely know, the risks of injury are higher driving to a trailhead than actually being on the trail. Everyone gets to decide for themselves what gear they will carry (some people don't even carry Bandaids!). I appreciate a devil's advocate and questioning the rationale of something that may feel extraneous or fear-based, and certainly don't take it personally. Happy hiking!
ETA: here's that video with the tree falling! th-cam.com/video/BYNbgFDSXSw/w-d-xo.html
@@WanderingSwitchback Great timing with that tree fall! Awesome. I've heard a couple at a distance and it's pretty trippy. That's why looking for widowmakers is a must do before setting up. A million to one shot though. And I appreciate you mentioning the fear component. It's just something that really gets to me. I'm not a fan. Especially when all it takes is a little education, humility and respect to move it out. But I've learned that some just gravitate towards fear. And that's fine. For them. But don't impose or expect it from others. Single women backpacking? Go for it. The farther you are from a popular trailhead the safer it is. And when you're out there nobody cares about your gender, race, fitness or any of it. At least I know I don't and I'm not alone. I live at 7K in a forest and am usually out five or six days a week. The ONLY thing that's ever got my shorts tight is wildfires. And I've been near a couple that have ignited while I've been out there. But that's something totally random. Otherwise, I don't think it takes much to stay safe. My mantra is "what if?" Works for me to keep me out of sketchy situations. It's just a matter of stopping and thinking. Rock, snow, water, weather, people. Covers it all. :)
Nice job. The other risk of removing a TQ is profound shock and cardiac arrest from the sudden drop in blood pressure. Resolvable in a clinical setting, but not so much during transport. BTW, I commented to another below, but I would like your take; I had to do a lot of palpable blood pressure in noisy ambulances. I can't feel a BP under 15 mmHg, so I had readings like " 60 / palp " of such. Can you actually feel very low PB using a distal pulse?
Excellent point about the sudden drop in BP!
Distal pulses would be a less than ideal place to try to palpate if a patient has low BP. Like you stated, 60/palp is what I have seen as well (we had one come in like that the other day- didn't make it). I could feel his femoral and carotid pulses (and his A/V pacemaker when he was pulseless), but not his radial pulse. Sometimes, the DBP is just too low to really identify. The lowest I saw documented on this guy from the Phillips was something like 40/28, but I can't imagine finding that manually, even in a quiet setting.
This is so important! I’m hoping to get an emergency first aid wilderness course this year. Thanks for clearing up the nonsense. I saw a first aid kit on amazo that had a rubber strap like the ones for giving blood listed as a tourniquet and was like whaaa? Maybe if I need an extra gear lash or water hang this would be useful….
There are so many misleading products out there. Those tourniquets work well for IV starts and blood draws, but definitely won’t stop a major bleed!
So in a life threatening situation if all I have is a belt or a t-shirt I shouldn’t even TRY??
You can certainly TRY it if you don't have anything else, but you won't get enough pressure without a windlass for a true arterial bleed, especially with how stretchy a shirt is, and a belt is too stiff for a windlass. I would not want to rely on this when it comes to saving a life. The few extra ounces for a good tourniquet is worth it.
I appreciate the information! However, I feel like you took to long to get to the application of the tourniquet.
John McHatton
I appreciate the feedback, John! Happy hiking!
Just watching gives me anxiety
That’s fair!
@WanderingSwitchback much respect to you and all the workers in youre field