Nick – what MD is suggesting using them and are they trained in trauma medicine? I am not but I know enough to know that I do not have the knowledge to use a tourniquet.

What you need first and foremost in knowledge. Equipment comes a long way lower priority and there is no point carrying equipment you do not know how to use.

tourniquet trousers were developed by an MD

For a specific purpose – to be used when you get your leg blown off

Do you know how to use a tourniquet? How long to leave it on befoer releasing? Or are you prepared to sacrifice limb? To bleed out from a major arterial wound is so ridiculously unlikely

No one, that’s NO ONE, uses tourniquets in a hospital setting; we would just press on the bleeding to stop it.

Currently being issued to all ambulance resources in my area, (with training to follow 🙄 ) Whether there’s actually any point is a separate argument, but very much in vogue at the moment.

Tourniquets are routinely used in theatre for orthopaedic surgery as well.

I’m an a&e charge nurse, but I must admit I’ve never bothered carrying a first aid kit in the 20 years I’ve been riding, even on multi day rides out in the middle of nowhere 😳 Someone has usually had a dressing and some paracetamol!
I also must admit I tend to take a back seat if anyone has a spill, with mates I’ll generally make sarc’y comments. On bigger group rides I’ve done, there is always someone else who wants to be the one to sort it all out and sit doing the handholding etc. Unless they were going to do something dangerous, I would happily leave them to it. I’ve only had one mate who had a proper smash, and obviously I sorted that to the best of my ability at the side of a muddy trail, then it was over to the air ambulance chaps.

“Tourniquets are routinely used in theatre for orthopaedic surgery as well.”

Mrs FD uses them almost daily in theatre, I think the limit is about 2hrs. She did tell me about 1 opp a colleague was doing though, where they forgot to take it off until about the 4 hr mark. The person was apparently always going to loose their leg anyhow, but if it had been a healthy person it could have been a bit unfortunate.

Does appear that the medical professionals tend not to bother with kit, where as people with less skills and knowledge do.

Does appear that the medical professionals tend not to bother with kit, where as people with less skills and knowledge do.

It’s an interesting one this. I’ve done both first-aid and outdoor leadership courses alongside medical professionals (including quite a few MDs). All of them were pretty humble about first-aid and admitted that they don’t get specific training on it and don’t have much of a clue.

Medical professionals don’t even get exemption from the First Aid training requirements for outdoor qualifications.

I’ve also had to deal with a few injuries out on the hill (and on the rugby pitch back in the day) where someone in the group was a MD. IME they exhibit extreme reluctance to get involved, to the point where I don’t bother asking the question any more.

Not knocking anyone here, I’m sure in a genuinely life-threatening situation, someone medically trained would do the very best they could, which would be a lot better than me or any other lay-person!

I’ve badly gashed my knee on two separate occasions when out riding and both times had to use my buff to stop the bleeding. I will be taking dressings out in future.

IME they exhibit extreme reluctance to get involved, to the point where I don’t bother asking the question any more.

More to do with liability and litigation than anything probably. Doctors are actually advised not to stop and assist by their proffessional bodies I am led to believe. Although probably a fair bit of ‘fish out of waterism’ mixed with a little ‘bus mans holiday’ probably. It’s like asking your mate the AA man if he wouldn’t mind just having a gander at your car in the trail centre car park because you’ve got a little clonking noise…

I’m well aware of the use of tourniquets in theatre, having worked in one for 10 years.

Those are big, wide, pneumatic tourniquets with inbuilt alarms to remind you that they’ve been on a while, and are not used to stop bleeding, but to provide a blood-free field for operating under.

Don’t use tourniquets…just press on the bit that’s bleeding.

“Doctors are actually advised not to stop and assist by their proffessional bodies I am led to believe.”

No I beleive its the opposite, I think its in their oath that they will help where and when ever they can.

Mrs FD is a Trauma & Orthopaedic surgeon, so knows a fair bit about most injuries.

Given Steveos scenario above I think Mrs FD would not be inclined to rush forward and help, as its not a life threatening situation and in fairness more trouble than its worth getting involved, and an ambulance crew would probably do a better job than her, because its what they deal with.

She has however stopped on 2 separate occassions at RTA’s one a person had been run over as Mrs FD was driving home from work, unfortunately the person died at the seen. I asked if having a first aid kit in the car would have made any difference and she said no, not at all. Even when the ambulance arrived she said nothing in the Ambulance could have kept the person going, but she did say that drugs and equipment in hospital could have kept the person going a bit longer.

The other was a person who was diabetic and hadnt taken their med’s and had passed out at the wheel whilst driving. When the ambulance crew came they couldnt get a line in to him so Mrs FD did it.

More to do with liability and litigation than anything probably. Doctors are actually advised not to stop and assist by their proffessional bodies I am led to believe.

That’s absolutely untrue, and the GMC would not be happy with anyone who was found to have failed to help in a potentially life threatening situation.

As for litigation we are expected to provide only that care which could be expected of us given our training and expertise and area of practice, ie a psychiatrist should be able to provide basic life support, a trauma specialist much more. There is an arguement that all Drs should have some advanced trauma training even at a basic level, most don’t & would not expect to need it in their normal practice.

Yeah, as stated it’s a requirement of the GMC (see ‘Duties of a Doctor’ – it’s on their website for all to see) to assist at any time if necessary. Although there are stories of people being sued for mismanaging a situation (E.g. on a plane) I understand that no one has ever successfully brought a claim to court.

I would happily say that I’m not an expert in first aid. I could probably fashion a sling but first aid simply isn’t part of my job. If there are others that are trained and keen to clean up scrapes and wounds – they’ll probably do a better job, plus it’s also a rare treat for them to put their skills to good use, stops them forgetting etc. On the other hand, if someone was seriously unwell, bleeding profusely, head/neck injuries etc, I’d be there to help out if I could.

TJ – see my link above (http://en.wikipedia.org/wiki/File:Ladder_of_Haemostasis.jpg)

I believe that’s taught as part of ATLS (Advanced trauma life support) – There is a role for tourniquets, but only after other methods have failed. With regards to tourniquet time, if you’re using a tourniquet appropriately (E.g. arterial bleeding that you can’t stop) the important thing is to get that person to a hospital ASAP. In the UK you’ll almost almost always be within the 2 hours maximum recommended.

But yeah, I don’t think anyone should be carrying tourniquets in their camelbak 😆

Superficial =- hence my point about not carrying kit you don’t know how to use

Everyone in the medical world knows doctors can’t put a bandage or a plaster on 🙂

TandemJeremy – Member
Everyone in the medical world knows doctors can’t put a bandage or a plaster on…..

…..if you have a dog you don’t need to learn how to bark

Badoom tish!

the world is nuanced not black and white. therefore I think it’s silly to say that “all tourniquets are bad m’kay”

none of my first aid kits include a tourniquet