MSA Training Weekend Saturday 18 th Sunday 19 th January 2014 Royal Lancaster Infirmary Education...

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