MSA Training Weekend

Saturday 18th Sunday 19th January 2014

Royal Lancaster Infirmary

Education Centre

Presented

By

Paramedic Mr Dave Stubbs

COMBAT APPLICATION TOURNIQUET C A T

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

• 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