By Jason Williams and Brian G. Anderson
Once students have mastered basic tourniquet applications, increase the challenge with these additional hands-on training tips to prepare LEOs for real-world applications.
1. Left, right or both hands. Applying a tourniquet with both hands in training makes sense when building basic skills, but once the basics are rooted it’s time to learn how to use one hand to deploy and apply. the withers. There may be situations where a hand is out of service due to injury or when it is necessary to keep a weapon in the dominant hand and the non-dominant hand must be used to apply the tourniquet. Application variants include self-application on the left and right arms as well as on the left and right legs and application on the arm or leg of a victim.
2. Time pressure. One method of instilling the need for speed is to ask class participants to estimate how long it will take to apply a tourniquet. With the estimates set and the group starting at the same time, start a stopwatch. Participants will most likely try to beat their own estimates and those of their friends, forcing them to work quickly.
When faced with a life-threatening bleeding, it’s the seconds, not the minutes that make the difference. A severed artery in an arm or leg can be fatal within minutes. Speed ââis essential and speed is achieved with practice and mental preparation.
3. Dim the lights. When it is time to use a tourniquet in the field, chances are the lighting is not as good as in the training room. Even during classroom training, greater fidelity can be achieved by turning off the lights and closing the blinds.
4. I can’t see. During initial or refresher training, participants will demonstrate their skill in applying the tourniquet with the lights on and eyes open. Once this skill has been demonstrated, participants can be instructed to apply tourniquets with their eyes closed. This is an important skill when considering the possibility of decreased vision due to pepper spray or other contaminants, blunt trauma to the head or eyes, or working in the area. darkness by chance or by tactical necessity. For complete darkness and an opportunity to train in a confined environment, a storage closet or similar area works well. Now is a good time to discuss the issues of using gun-mounted lights to illuminate a victim.
5. Turn it on. Dark rooms provide a realistic training environment, but more realism can be achieved with the addition of flashing red / blue lights. Old dashboard lights that have been removed from vehicles can add realism to a training session, and the store doing the installations may have old lights that can be acquired just for training. Since modern warning lights are built with LEDs and consume little power, 12 volt rechargeable compact batteries can be used in training exercises.
6. Turn up the volume. The dark rooms and the flashing lights are awesome, and now the only thing missing are the sounds of an incident scene. It is easy to output quality sound during training through the use of a little bit of simple technology. For hardware, MP3 players, smartphones or laptops are easy to use and they can often be paired with large speakers via Bluetooth. Public education offices can have large speakers that are used for school demonstrations and other public events that can be perfect for the classroom. When it’s time to add sound to training, there are several choices available to you. Good audio content includes radio traffic from a previous dynamic incident, the noise of the crowd, a bark from the K-9, and the sound effects of sirens, horns and helicopters. These can be found and downloaded from special effects websites or recordings can be made on site. Other audio choices include club music, upbeat foreign language music, and heavy metal music.
7. Smoke detectors. Unloading firearms in confined spaces can activate smoke detectors, increasing audible distractions. This effect can be added to training with an inexpensive battery operated smoke detector. To activate the smoke detector on demand, a spring clip can be used to press the smoke detector test button to activate the alarm.
8. Get off! If training is limited to a classroom setting, training participants should rise from chairs and get on the floor or under classroom tables to provide more realistic conditions in which to assess a victim and apply a tourniquet.
9. Put your equipment out of the way. Drop leg holsters, gas mask pouches, arm guards, spare magazine pouches, and smartphones in pockets can prevent a tourniquet from applying the circumferential pressure necessary to function properly. Unbuckle and swing this equipment out of the way or out of pockets before applying a tourniquet. If the limb is impaled with an object, the running end of the tourniquet may need to be removed from the buckle and the limb wrapped in a strap and reconnected to the buckle.
10. Officer stuck in vehicle. With a good foundational skill base established, consider the real-world challenges that agents may face in the field. An example is a car accident with a stuck door that cannot be opened and the driver needs a tourniquet on the leg. Leaning through the driver’s side window and applying a tourniquet to the driver’s leg will likely mean that the tourniquet cannot be applied in the buckle configuration, so the strap will need to be removed from the buckle, slipped under the driver’s leg. then reattached before tightening.
11. Work with a partner. When it is evident that a tourniquet is needed for a victim, one agent can apply direct pressure to slow the bleeding while another agent applies a tourniquet. The amount of bleeding that is avoided by direct pressure can make a difference in the victim’s survival.
Another scenario is to apply a tourniquet to the driver’s leg while working on the passenger side of the vehicle. Working from a kneeling position, over the center console and the laptop can test basic skills.
Finally, it is our duty to respect the combatants. The invention and widespread use of tactical tourniquets is a direct result of a need identified by combatants, physicians and trauma surgeons in Iraq and Afghanistan. Learning and practicing tourniquet techniques honor their sacrifice and their commitment to saving lives.
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About the authors
Jason Williams is a 20-year veteran of the Aventura Police Department in Miami-Dade County, Florida. Jason has been a member of the multi-agency SWAT team for 16 years, as well as a team leader for 12 years. He is currently certified in several instructor areas including Active Shooter Response, Less Lethal, Ballistic Shield, Mechanical / Ballistic Breaker and several others. Jason was a K-9 dog handler for 12 years, working two dual purpose dogs. His experience as a SWAT team leader / member and K-9 manager pushed him to become a better tactician and share his expertise.
Brian G. Anderson is a retired Battalion Commander and Paramedic from Miami-Dade, Fla. Fire Rescue. Prior to his retirement, he focused on the development of fire rescue active fire procedures and interagency active fire drills. He is an instructor at Palm Beach State College and is also a volunteer instructor with Trauma Training Group, Inc., an organization that offers free Stop the Bleed training in South Florida. He has provided training on bleeding control to staff in private, public and charter schools and to members of city and county law enforcement agencies.