Grey

I’m not second guessing his actions, but I sense that people think I am. I was simply pointing out a possible reason for the comment that Bitter highlighted. But since then I saw another article that mentioned that he had medical training and worked in EMS. So my original point doesn’t really apply anymore, at least with regards to him.

GeorgeH,

That would seem to argue for more training, rather than trying to use a potentially dangerous technique without training.

The new torniquet’s based on the original Israeli design, have very good instructions which make them very self explanatory, printed directly on the wrapper of the torniquet. The new tourniquets are designed to be used one handed for extreme situations, such as the one Mr. Bruley was in. He did what he could with what he had, lets leave it at that and quit second guessing the man who was on the scene. We don’t know what was going on in his head nor do we know of the tactical situation he faced. He did a good job with his limited knowledge and if his former employers hadn’t tried to deflect any criticisms of themselves, this issue never would have been brought up.

Grey

In general, outside the military, though, they’re discouraged because most people don’t have the needed training. There are whole lot of ways to do them wrong, which is why current (non-military/civilian) training deemphasizes them.

Grey

U.S. Army 85-89 Medic (91A)
EMT-D Missouri 94-98
VFD Missouri 94-98

Bitter, you raise some excellent points about Colin not being on the clock at the time of the incident, as well as their alternatives to straight out termination.

Aubrey, with my wife working at the main hospital here in Boise, she also agrees that direct pressure is the preferred approach, and a tourniquet should be a last resort. But — as you pointed out — Colin had no idea what else might happen. It would have been difficult to maintain direct pressure if the shooter appeared and Colin ended up dodging bullets.

I was fortunate enough to interview Colin twice, and I also spoke with the victim, Tonnetta Lee. Overviews of my conversations with Colin can be found on my Workplace Excellence blog.

Suffice it to say, though, that Bitter is right on the money in the above post.

Anyhow, I was using the CERT manual as an illustration of the preferred methods for controlling bleeding. Tourniquets are not included in the participant manual and are left to the local agency to decide to include (or not).

Disaster, too, is different than attack. It may be prudent to use a tourniquet if it is possible that the attack may resume, resulting in either further wounds to the victim or the provider having to abandon victim care.

Most people think that getting shot in the leg is probably not life threatening. But if the femoral artery is hit, the victim can bleed out very fast.

Still, I’d try direct pressure and elevation and then use a pressure point before attempting a tourniquet. There is a pressure point at the groin where the femoral can be blocked by using pressure from the heel of the hand.

This is also what we teach in CERT (I’m an instructor for our local CERT). Here’s a link to the participant’s manual that has the section on controlling bleeding (from CERT Unit 3 – Disaster Medical Operations Part 1).

Direct pressure, elevation, and pressure points are preferred. Only if all of these fail, and only with great care, should you consider using a tourniquet. He related one instance to us where a carpenter had cut off several fingers with a saw. His friends, thinking they were helping, put a tourniquet on his arm. He ended up losing most of the arm due to damage done by the tourniquet. If they’d given pressure and elevation time to work, it’s likely he would still have his arm and hand (minus the fingers).

Once one is applied, it must not be removed except by trained medical personnel. A tourniquet cuts off blood flow to the entire limb below where it’s tied. Loss of blood flow causes the cells to slowly die due to loss of oxygen. As the cells die, they release various chemicals into the tissues and the blood becomes acidic. When the tourniquet is released, that acidic blood flows through the body and can cause shock and/or death if not handled correctly.

Best not to use one unless you have no choice.

Anyhow, you’re correct that as a good samaritan he should have legal protection as he didn’t seem to be operating out of malice. And it doesn’t excuse the actions of his management, either in firing him or attempting to smear him after the fact to cover their own sorry asses. I just thought I’d explain the issue with the tourniquet.