right now as a medical student my life was spent in the books but before
was spent in the books but before
was spent in the books but before beginning my journey medical school I
beginning my journey medical school I
beginning my journey medical school I was an Army Ranger and deployed eight
was an Army Ranger and deployed eight
was an Army Ranger and deployed eight times to combat I want to share a story
times to combat I want to share a story
times to combat I want to share a story with you about one of those deployments
with you about one of those deployments
with you about one of those deployments about Zack Greiner and how turning could
about Zack Greiner and how turning could
about Zack Greiner and how turning could save his life this is Zack on our
save his life this is Zack on our
save his life this is Zack on our deployment 2010 on October 1st of that
deployment 2010 on October 1st of that
deployment 2010 on October 1st of that year my unit was on a mission and we
year my unit was on a mission and we
year my unit was on a mission and we were using an Afghan house as a
were using an Afghan house as a
were using an Afghan house as a defensive position we were heavily
defensive position we were heavily
defensive position we were heavily engaged with the enemy throughout the
engaged with the enemy throughout the
engaged with the enemy throughout the morning
morning
morning machine-gun fire mortars rockets snipers
machine-gun fire mortars rockets snipers
machine-gun fire mortars rockets snipers and about 10:00 a.m. I’m order landed
and about 10:00 a.m. I’m order landed
and about 10:00 a.m. I’m order landed right in the middle of the yard and it
right in the middle of the yard and it
right in the middle of the yard and it wounded Zack along with 12 others
wounded Zack along with 12 others
wounded Zack along with 12 others shrapnel from the mortar ripped through
shrapnel from the mortar ripped through
shrapnel from the mortar ripped through Zacks flesh carrying open several
Zacks flesh carrying open several
Zacks flesh carrying open several arteries in his legs and when I was
arteries in his legs and when I was
arteries in his legs and when I was treating an even more severely wounded
treating an even more severely wounded
treating an even more severely wounded casualty a ranger medic grab Zack and he
casualty a ranger medic grab Zack and he
casualty a ranger medic grab Zack and he pulled him out of the direct line of
pulled him out of the direct line of
pulled him out of the direct line of fire pulled him to safety and he put two
fire pulled him to safety and he put two
fire pulled him to safety and he put two tourniquets on his legs but it wasn’t
tourniquets on his legs but it wasn’t
tourniquets on his legs but it wasn’t enough he continued to bleed so he put
enough he continued to bleed so he put
enough he continued to bleed so he put on two more tourniquets and finally a
on two more tourniquets and finally a
on two more tourniquets and finally a four tourniquet supplied the bleeding
four tourniquet supplied the bleeding
four tourniquet supplied the bleeding was controlled about an hour later a UK
was controlled about an hour later a UK
was controlled about an hour later a UK medevac helicopter would pick Zack up
medevac helicopter would pick Zack up
medevac helicopter would pick Zack up take him to a combat hospital for
take him to a combat hospital for
take him to a combat hospital for further care incredibly he made a
further care incredibly he made a
further care incredibly he made a complete recovery and even deployed to
complete recovery and even deployed to
complete recovery and even deployed to Afghanistan the very next year this is
Afghanistan the very next year this is
Afghanistan the very next year this is just one of thousands of stories of how
just one of thousands of stories of how
just one of thousands of stories of how tourniquets have helped save lives in
tourniquets have helped save lives in
tourniquets have helped save lives in the battlefield the wars in Afghanistan
the battlefield the wars in Afghanistan
the battlefield the wars in Afghanistan and Iraq have resulted in an
and Iraq have resulted in an
and Iraq have resulted in an unprecedented survival rate however we
unprecedented survival rate however we
unprecedented survival rate however we still have a 24 to 26 percent
still have a 24 to 26 percent
still have a 24 to 26 percent preventable death rate now we can define
preventable death rate now we can define
preventable death rate now we can define for the no death as an injury in which a
for the no death as an injury in which a
for the no death as an injury in which a death in which the injury results in a
death in which the injury results in a
death in which the injury results in a death but if it was treated
death but if it was treated
death but if it was treated appropriately they could have survived
appropriately they could have survived
appropriately they could have survived and there are three major causes of
and there are three major causes of
and there are three major causes of preventable death one massive bleeding
preventable death one massive bleeding
preventable death one massive bleeding from an extremity to a collapsed lung or
from an extremity to a collapsed lung or
from an extremity to a collapsed lung or tension develops in the chest and three
tension develops in the chest and three
tension develops in the chest and three and air
and air
and air obstruction now you can see by far
obstruction now you can see by far
obstruction now you can see by far leading is the major cause of
leading is the major cause of
leading is the major cause of preventable death and we’ve known about
preventable death and we’ve known about
preventable death and we’ve known about this since the Vietnam War dr. Morgan
this since the Vietnam War dr. Morgan
this since the Vietnam War dr. Morgan and Navy surgeon during the Vietnam War
and Navy surgeon during the Vietnam War
and Navy surgeon during the Vietnam War said this about self helping first aid
said this about self helping first aid
said this about self helping first aid in an article little if any improvement
in an article little if any improvement
in an article little if any improvement has been made in this phase of treatment
has been made in this phase of treatment
has been made in this phase of treatment of combat wounds in the past 100 years
of combat wounds in the past 100 years
of combat wounds in the past 100 years what is even more astonishing nothing
what is even more astonishing nothing
what is even more astonishing nothing would change to the next 31 years you
would change to the next 31 years you
would change to the next 31 years you see in the beginning of the wars
see in the beginning of the wars
see in the beginning of the wars Afghanistan Iraq combat medics still
Afghanistan Iraq combat medics still
Afghanistan Iraq combat medics still relied on Civil War vintage technology
relied on Civil War vintage technology
relied on Civil War vintage technology for pain management and these treatment
for pain management and these treatment
for pain management and these treatment methods not designed for the battlefield
methods not designed for the battlefield
methods not designed for the battlefield this was despite the development of
this was despite the development of
this was despite the development of tactical combat casualty care or
tactical combat casualty care or
tactical combat casualty care or teachable C you see after Somalia the
teachable C you see after Somalia the
teachable C you see after Somalia the Rangers and other Special Operations
Rangers and other Special Operations
Rangers and other Special Operations personnel they got together and they
personnel they got together and they
personnel they got together and they were looking over the different
were looking over the different
were looking over the different casualties the different wounded the
casualties the different wounded the
casualties the different wounded the different ki a and they were doing this
different ki a and they were doing this
different ki a and they were doing this to try identify better means to train
to try identify better means to train
to try identify better means to train for combat casualties at the same time
for combat casualties at the same time
for combat casualties at the same time in 1996 dr. Frank Butler and colleagues
in 1996 dr. Frank Butler and colleagues
in 1996 dr. Frank Butler and colleagues published their paper tactical combat
published their paper tactical combat
published their paper tactical combat casualty care in special operations the
casualty care in special operations the
casualty care in special operations the goal was good medicine with good tactics
goal was good medicine with good tactics
goal was good medicine with good tactics but only a few units implemented this
but only a few units implemented this
but only a few units implemented this before 9/11 and one of what they did was
before 9/11 and one of what they did was
before 9/11 and one of what they did was they focused on those three major
they focused on those three major
they focused on those three major preventable causes of death especially
preventable causes of death especially
preventable causes of death especially early tourniquet application my previous
early tourniquet application my previous
early tourniquet application my previous unit the 75th Ranger Regiment I was a
unit the 75th Ranger Regiment I was a
unit the 75th Ranger Regiment I was a physician assistant and I was charged
physician assistant and I was charged
physician assistant and I was charged with overseeing medical training for the
with overseeing medical training for the
with overseeing medical training for the unit and there we taught every single
unit and there we taught every single
unit and there we taught every single ranger how to identify and treat those
ranger how to identify and treat those
ranger how to identify and treat those three major preventable causes of death
three major preventable causes of death
three major preventable causes of death this enabled the 75th Ranger Regiment to
this enabled the 75th Ranger Regiment to
this enabled the 75th Ranger Regiment to eliminate preventable death on the
eliminate preventable death on the
eliminate preventable death on the battlefield
battlefield
battlefield we had zero preventable death on the
we had zero preventable death on the
we had zero preventable death on the battlefield and all we did was to follow
battlefield and all we did was to follow
battlefield and all we did was to follow the recommendations from the Committee
the recommendations from the Committee
the recommendations from the Committee on tactical combat casualty care this
on tactical combat casualty care this
on tactical combat casualty care this was a feat has never been reproduced has
was a feat has never been reproduced has
was a feat has never been reproduced has never been accomplished by any
never been accomplished by any
never been accomplished by any unit in the history of the US military
unit in the history of the US military
unit in the history of the US military and you know the Committee on tactical
and you know the Committee on tactical
and you know the Committee on tactical combat character Care recommends using
combat character Care recommends using
combat character Care recommends using one of two tourniquets for major
one of two tourniquets for major
one of two tourniquets for major bleeding Brookshire me leading the
bleeding Brookshire me leading the
bleeding Brookshire me leading the combat application tourniquet or cat or
combat application tourniquet or cat or
combat application tourniquet or cat or the self tactical tourniquet soft tea
the self tactical tourniquet soft tea
the self tactical tourniquet soft tea you see before 2006 although at the time
you see before 2006 although at the time
you see before 2006 although at the time we were the Rangers we were using an
we were the Rangers we were using an
we were the Rangers we were using an effective ratchet tourniquet like you
effective ratchet tourniquet like you
effective ratchet tourniquet like you see there most people were being told
see there most people were being told
see there most people were being told not to use tourniquets most units are
not to use tourniquets most units are
not to use tourniquets most units are saying don’t use tourniquets and further
saying don’t use tourniquets and further
saying don’t use tourniquets and further our most earnest were improvised after
our most earnest were improvised after
our most earnest were improvised after 2006 turnings became more widespread the
2006 turnings became more widespread the
2006 turnings became more widespread the US military so how do we know they work
US military so how do we know they work
US military so how do we know they work well back to Vietnam
well back to Vietnam
well back to Vietnam so in Vietnam extremity bleeding death
so in Vietnam extremity bleeding death
so in Vietnam extremity bleeding death from extreme bleeding was 7.4 percent of
from extreme bleeding was 7.4 percent of
from extreme bleeding was 7.4 percent of total combat fatalities up to 2000 and
total combat fatalities up to 2000 and
total combat fatalities up to 2000 and if you look at Iraq and Afghanistan
if you look at Iraq and Afghanistan
if you look at Iraq and Afghanistan after 2006 when in terms were just
after 2006 when in terms were just
after 2006 when in terms were just starting to be used death from external
starting to be used death from external
starting to be used death from external eating was about 7.8 percent of total
eating was about 7.8 percent of total
eating was about 7.8 percent of total combat fatalities from 2006 to 2011
combat fatalities from 2006 to 2011
combat fatalities from 2006 to 2011 another study demonstrated that death
another study demonstrated that death
another study demonstrated that death from external bleeding was 2.6 percent
from external bleeding was 2.6 percent
from external bleeding was 2.6 percent of combat fatalities someone argue that
of combat fatalities someone argue that
of combat fatalities someone argue that depend on the data you look at it
depend on the data you look at it
depend on the data you look at it actually may be lower so right how you
actually may be lower so right how you
actually may be lower so right how you look at it there was at least a 67
look at it there was at least a 67
look at it there was at least a 67 percent decrease in death from extremity
percent decrease in death from extremity
percent decrease in death from extremity bleeding so how does this relate to the
bleeding so how does this relate to the
bleeding so how does this relate to the civilian sector well of the 147 thousand
civilian sector well of the 147 thousand
civilian sector well of the 147 thousand deaths from trauma in 2014 20 percent or
deaths from trauma in 2014 20 percent or
deaths from trauma in 2014 20 percent or thirty thousand people could have
thirty thousand people could have
thirty thousand people could have survived that’s the world we live in we
survived that’s the world we live in we
survived that’s the world we live in we live in a world people know how to call
live in a world people know how to call
live in a world people know how to call 9-1-1 they can consult a victim but they
9-1-1 they can consult a victim but they
9-1-1 they can consult a victim but they don’t really know what to do about
don’t really know what to do about
don’t really know what to do about trauma bleeding is it a fear of
trauma bleeding is it a fear of
trauma bleeding is it a fear of infectious diseases or just like the
infectious diseases or just like the
infectious diseases or just like the military is there some sort of
military is there some sort of
military is there some sort of tourniquet phobia out there those of us
tourniquet phobia out there those of us
tourniquet phobia out there those of us who have promoted early tourniquet use
who have promoted early tourniquet use
who have promoted early tourniquet use have heard it all by learning that
have heard it all by learning that
have heard it all by learning that tourniquets are dangerous should only be
tourniquets are dangerous should only be
tourniquets are dangerous should only be used as a last resort this is a medical
used as a last resort this is a medical
used as a last resort this is a medical herb in’ myth that has cost the lives of
herb in’ myth that has cost the lives of
herb in’ myth that has cost the lives of thousands of trauma victims many
thousands of trauma victims many
thousands of trauma victims many thousands of tourniquets have been used
thousands of tourniquets have been used
thousands of tourniquets have been used by the US military
by the US military
by the US military Iraq and Afghanistan and the result is
Iraq and Afghanistan and the result is
Iraq and Afghanistan and the result is zero limbs loss from that tourniquet use
zero limbs loss from that tourniquet use
zero limbs loss from that tourniquet use furthermore tourniquets are used on a
furthermore tourniquets are used on a
furthermore tourniquets are used on a regular basis in orthopedic surgeries
regular basis in orthopedic surgeries
regular basis in orthopedic surgeries and two hours of tourniquet time is very
and two hours of tourniquet time is very
and two hours of tourniquet time is very safe
safe
safe fortunately stories like Zach’s aren’t
fortunately stories like Zach’s aren’t
fortunately stories like Zach’s aren’t limited to far-off countries like
limited to far-off countries like
limited to far-off countries like Afghanistan here we do see stories how
Afghanistan here we do see stories how
Afghanistan here we do see stories how police officers use them on a daily
police officers use them on a daily
police officers use them on a daily basis I do they use tourniquets these
basis I do they use tourniquets these
basis I do they use tourniquets these other hemostatic agents not only on
other hemostatic agents not only on
other hemostatic agents not only on themselves they use on bystanders use it
themselves they use on bystanders use it
themselves they use on bystanders use it on criminals they’re often the first
on criminals they’re often the first
on criminals they’re often the first people on the scene why is it that I can
people on the scene why is it that I can
people on the scene why is it that I can teach people that go to combat I can
teach people that go to combat I can
teach people that go to combat I can teach police officers how to identify
teach police officers how to identify
teach police officers how to identify and treat those three major preventable
and treat those three major preventable
and treat those three major preventable causes of death but the average u.s.
causes of death but the average u.s.
causes of death but the average u.s. citizen it seems foreign compare this of
citizen it seems foreign compare this of
citizen it seems foreign compare this of CPR or over 12 million people per year
CPR or over 12 million people per year
CPR or over 12 million people per year learn how to do CPR we all know about
learn how to do CPR we all know about
learn how to do CPR we all know about CPR we all see the automated external
CPR we all see the automated external
CPR we all see the automated external defibrillators on the wall I would bet
defibrillators on the wall I would bet
defibrillators on the wall I would bet if we there’s a group of people that
if we there’s a group of people that
if we there’s a group of people that didn’t know how to do CPR and someone
didn’t know how to do CPR and someone
didn’t know how to do CPR and someone suffered a cardiac arrest that people
suffered a cardiac arrest that people
suffered a cardiac arrest that people figure out how to do it and if you don’t
figure out how to do it and if you don’t
figure out how to do it and if you don’t know how to do it that 9-1-1 operator
know how to do it that 9-1-1 operator
know how to do it that 9-1-1 operator can give you instructions you can even
can give you instructions you can even
can give you instructions you can even get instructions from amazon’s echo
get instructions from amazon’s echo
get instructions from amazon’s echo device this all happens despite the fact
device this all happens despite the fact
device this all happens despite the fact that some us studies say that out of the
that some us studies say that out of the
that some us studies say that out of the hospital cardiac arrest survival rates
hospital cardiac arrest survival rates
hospital cardiac arrest survival rates are as low as point six percent so we
are as low as point six percent so we
are as low as point six percent so we have you know low instead of cardiac
have you know low instead of cardiac
have you know low instead of cardiac arrest here only places like college
arrest here only places like college
arrest here only places like college campuses we have potentially very low
campuses we have potentially very low
campuses we have potentially very low out-of-hospital survival rates does that
out-of-hospital survival rates does that
out-of-hospital survival rates does that impede our efforts to help those in
impede our efforts to help those in
impede our efforts to help those in cardiac arrest
cardiac arrest
cardiac arrest no and it shouldn’t if we can save the
no and it shouldn’t if we can save the
no and it shouldn’t if we can save the life we’ve spoke forth the effort
life we’ve spoke forth the effort
life we’ve spoke forth the effort where’s the effort to save the lives for
where’s the effort to save the lives for
where’s the effort to save the lives for bleeding in the wake of the Sandy Hook
bleeding in the wake of the Sandy Hook
bleeding in the wake of the Sandy Hook shooting subject matter experts came
shooting subject matter experts came
shooting subject matter experts came together and they published the Hartford
together and they published the Hartford
together and they published the Hartford consensus and these are guidelines for
consensus and these are guidelines for
consensus and these are guidelines for people who may find themselves in an
people who may find themselves in an
people who may find themselves in an active shooter situation the concept was
active shooter situation the concept was
active shooter situation the concept was easy
easy
easy there should be early and definitive
there should be early and definitive
there should be early and definitive controlled external bleeding and that
controlled external bleeding and that
controlled external bleeding and that tourniquets in hemostatic dressings
tourniquets in hemostatic dressings
tourniquets in hemostatic dressings would help make that possible yet still
would help make that possible yet still
would help make that possible yet still little is known about this
little is known about this
little is known about this or how to stop bleeding for hours and
or how to stop bleeding for hours and
or how to stop bleeding for hours and hours in the CPR yet bleeding control
hours in the CPR yet bleeding control
hours in the CPR yet bleeding control course is as short as two and a half
course is as short as two and a half
course is as short as two and a half hours and easy to implement just this
hours and easy to implement just this
hours and easy to implement just this last year in 2016 a report titled a
last year in 2016 a report titled a
last year in 2016 a report titled a national trauma care system integrating
national trauma care system integrating
national trauma care system integrating military and civilian trauma systems to
military and civilian trauma systems to
military and civilian trauma systems to achieve zero preventable deaths after
achieve zero preventable deaths after
achieve zero preventable deaths after injury was published very long title but
injury was published very long title but
injury was published very long title but what it did is to help identify some of
what it did is to help identify some of
what it did is to help identify some of the preventable deaths we have the
the preventable deaths we have the
the preventable deaths we have the United States and there were also 11
United States and there were also 11
United States and there were also 11 recommendations that came along with it
recommendations that came along with it
recommendations that came along with it and they were all aimed at helping the
and they were all aimed at helping the
and they were all aimed at helping the military and civilian trauma systems and
military and civilian trauma systems and
military and civilian trauma systems and that experts come together to help the
that experts come together to help the
that experts come together to help the United States reach zero preventable
United States reach zero preventable
United States reach zero preventable deaths there have been over two million
deaths there have been over two million
deaths there have been over two million deaths from trauma since 2001 and in the
deaths from trauma since 2001 and in the
deaths from trauma since 2001 and in the past decade there were over 400,000
past decade there were over 400,000
past decade there were over 400,000 potentially survivable casualties trauma
potentially survivable casualties trauma
potentially survivable casualties trauma is the number one cause of productive
is the number one cause of productive
is the number one cause of productive life years lost before the age of 75 and
life years lost before the age of 75 and
life years lost before the age of 75 and the number one cause of death for people
the number one cause of death for people
the number one cause of death for people under 44 imagine what and where these
under 44 imagine what and where these
under 44 imagine what and where these 400,000 people will be doing today
400,000 people will be doing today
400,000 people will be doing today events like Sandy Hook Boston and
events like Sandy Hook Boston and
events like Sandy Hook Boston and Orlando have shown that a terrorist act
Orlando have shown that a terrorist act
Orlando have shown that a terrorist act or an active shooter could happen
or an active shooter could happen
or an active shooter could happen anywhere anytime
anywhere anytime
anywhere anytime dr. Cristina Hernan an emergency
dr. Cristina Hernan an emergency
dr. Cristina Hernan an emergency physician at the Boston bombing coined
physician at the Boston bombing coined
physician at the Boston bombing coined the term disaster gap and this is a time
the term disaster gap and this is a time
the term disaster gap and this is a time between when a disaster happens or
between when a disaster happens or
between when a disaster happens or traumatic event happens and emergency
traumatic event happens and emergency
traumatic event happens and emergency personnel arrive this is also the time
personnel arrive this is also the time
personnel arrive this is also the time when people die for Venerable causes as
when people die for Venerable causes as
when people die for Venerable causes as further perspective do you realize you
further perspective do you realize you
further perspective do you realize you can bleed out and die within two to
can bleed out and die within two to
can bleed out and die within two to three months from your femoral artery
three months from your femoral artery
three months from your femoral artery now I understand that a traumatic event
now I understand that a traumatic event
now I understand that a traumatic event or a terrorist act is going to catch
or a terrorist act is going to catch
or a terrorist act is going to catch anyone off-guard but I know as a PA and
anyone off-guard but I know as a PA and
anyone off-guard but I know as a PA and a Doctrine training that our response
a Doctrine training that our response
a Doctrine training that our response could be optimized within control
could be optimized within control
could be optimized within control training for all because proper training
training for all because proper training
training for all because proper training and preparation enables you to react and
and preparation enables you to react and
and preparation enables you to react and respond it’s probably pretty unlikely
respond it’s probably pretty unlikely
respond it’s probably pretty unlikely you’ll be at a terrorist act or get
you’ll be at a terrorist act or get
you’ll be at a terrorist act or get caught up at an active shooter situation
caught up at an active shooter situation
caught up at an active shooter situation but how like is you may see a car
but how like is you may see a car
but how like is you may see a car accident
accident
accident have an accident at home something could
have an accident at home something could
have an accident at home something could happen here on campus could be your
happen here on campus could be your
happen here on campus could be your place of employment are you prepared do
place of employment are you prepared do
place of employment are you prepared do you know how to prepare yourself do you
you know how to prepare yourself do you
you know how to prepare yourself do you know how a tourniquet works I’m going to
know how a tourniquet works I’m going to
know how a tourniquet works I’m going to show you so what we’ve got here first
show you so what we’ve got here first
show you so what we’ve got here first are two different types of public access
are two different types of public access
are two different types of public access building kits right there available a
building kits right there available a
building kits right there available a lot of different places they just happen
lot of different places they just happen
lot of different places they just happen to be from the same makers who make the
to be from the same makers who make the
to be from the same makers who make the cat and the soft team so first we’re
cat and the soft team so first we’re
cat and the soft team so first we’re going to talk through the how or what
going to talk through the how or what
going to talk through the how or what the parts of a tourniquet are so my
the parts of a tourniquet are so my
the parts of a tourniquet are so my partner Mike here will be demonstrating
partner Mike here will be demonstrating
partner Mike here will be demonstrating the soft key and I will be demonstrating
the soft key and I will be demonstrating
the soft key and I will be demonstrating the cat tourniquet first thing we’re
the cat tourniquet first thing we’re
the cat tourniquet first thing we’re going out is the strap right this thing
going out is the strap right this thing
going out is the strap right this thing needs to be at least one and a half
needs to be at least one and a half
needs to be at least one and a half inches long or what I’m sorry what
inches long or what I’m sorry what
inches long or what I’m sorry what happens is wide because the wider it is
happens is wide because the wider it is
happens is wide because the wider it is less pressure you need to stop the
less pressure you need to stop the
less pressure you need to stop the bleeding and this also means that the
bleeding and this also means that the
bleeding and this also means that the wider it is the less pressure the less
wider it is the less pressure the less
wider it is the less pressure the less damage you’re going to do to the
damage you’re going to do to the
damage you’re going to do to the underlying tissues right next the buckle
underlying tissues right next the buckle
underlying tissues right next the buckle as you can see mike has his down there
as you can see mike has his down there
as you can see mike has his down there mine has already been routed through the
mine has already been routed through the
mine has already been routed through the scrubs are being routed buckle you’re
scrubs are being routed buckle you’re
scrubs are being routed buckle you’re gonna need this is tighten down on the
gonna need this is tighten down on the
gonna need this is tighten down on the extremity third is the windlass and the
extremity third is the windlass and the
extremity third is the windlass and the windlass is actually the part that helps
windlass is actually the part that helps
windlass is actually the part that helps stop the leading so we’re going to twist
stop the leading so we’re going to twist
stop the leading so we’re going to twist this until the bleeding stops once you
this until the bleeding stops once you
this until the bleeding stops once you get that done it has to be put in some
get that done it has to be put in some
get that done it has to be put in some sort of device that secures it right so
sort of device that secures it right so
sort of device that secures it right so some sort of retainer so when you
some sort of retainer so when you
some sort of retainer so when you compare to a bleeding cavity you can
compare to a bleeding cavity you can
compare to a bleeding cavity you can always put direct pressure on that wound
always put direct pressure on that wound
always put direct pressure on that wound right if that doesn’t work or if you do
right if that doesn’t work or if you do
right if that doesn’t work or if you do have a strictly tourniquet you simply
have a strictly tourniquet you simply
have a strictly tourniquet you simply put the tourniquet on two to four inches
put the tourniquet on two to four inches
put the tourniquet on two to four inches above the wound and you’re going to
above the wound and you’re going to
above the wound and you’re going to tighten it down
tighten it down
tighten it down put the strap through the buckle and
put the strap through the buckle and
put the strap through the buckle and make sure it’s wrapped all the way
make sure it’s wrapped all the way
make sure it’s wrapped all the way around next thing you do is you’re going
around next thing you do is you’re going
around next thing you do is you’re going to tighten this tourniquet until you see
to tighten this tourniquet until you see
to tighten this tourniquet until you see the bleeding stopped once that bleeding
the bleeding stopped once that bleeding
the bleeding stopped once that bleeding is stopped
is stopped
is stopped you put the tourniquet into its retainer
you put the tourniquet into its retainer
you put the tourniquet into its retainer in the case of the cat tourniquet it
in the case of the cat tourniquet it
in the case of the cat tourniquet it does have a piece of velcro you can
does have a piece of velcro you can
does have a piece of velcro you can place over the top but each the softy
place over the top but each the softy
place over the top but each the softy has a different mechanism just make sure
has a different mechanism just make sure
has a different mechanism just make sure you understand how that works whatever
you understand how that works whatever
you understand how that works whatever turn you’re working with what you’re
turn you’re working with what you’re
turn you’re working with what you’re going to do next you’re going to write
going to do next you’re going to write
going to do next you’re going to write down the time time is important because
down the time time is important because
down the time time is important because when I say two hours they’re trying to
when I say two hours they’re trying to
when I say two hours they’re trying to get
get
get is safe what happens in a unique
is safe what happens in a unique
is safe what happens in a unique situation to where you may be there for
situation to where you may be there for
situation to where you may be there for hours on end when that casually gets to
hours on end when that casually gets to
hours on end when that casually gets to the hospital they need to know exactly
the hospital they need to know exactly
the hospital they need to know exactly when time that turnin went on because
when time that turnin went on because
when time that turnin went on because you know it’s safer to it’s better to
you know it’s safer to it’s better to
you know it’s safer to it’s better to lose a limb than to lose your life so
lose a limb than to lose your life so
lose a limb than to lose your life so never take off a tourniquet once it’s on
never take off a tourniquet once it’s on
never take off a tourniquet once it’s on finally what can you do you do need to
finally what can you do you do need to
finally what can you do you do need to call 9-1-1 keep your casualty safe by
call 9-1-1 keep your casualty safe by
call 9-1-1 keep your casualty safe by the way this just isn’t for other people
the way this just isn’t for other people
the way this just isn’t for other people you can apply a tourniquet to yourself
you can apply a tourniquet to yourself
you can apply a tourniquet to yourself and in case of the cat tourniquet you
and in case of the cat tourniquet you
and in case of the cat tourniquet you can use it one-handed on your upper
can use it one-handed on your upper
can use it one-handed on your upper extremity we have a unique situation
extremity we have a unique situation
extremity we have a unique situation before us if we can stick with the
before us if we can stick with the
before us if we can stick with the status quo or we can change our approach
status quo or we can change our approach
status quo or we can change our approach to trauma care right across roads I’m
to trauma care right across roads I’m
to trauma care right across roads I’m part of a group of medical professionals
part of a group of medical professionals
part of a group of medical professionals pushing hard for zero preventable deaths
pushing hard for zero preventable deaths
pushing hard for zero preventable deaths but we can’t do it on our own we can’t
but we can’t do it on our own we can’t
but we can’t do it on our own we can’t do it without each and every one of you
do it without each and every one of you
do it without each and every one of you if we can eliminate preventable death in
if we can eliminate preventable death in
if we can eliminate preventable death in the chaos of war why can’t we do it in
the chaos of war why can’t we do it in
the chaos of war why can’t we do it in the United States so who among you has
the United States so who among you has
the United States so who among you has what it takes to stand up lead Texas A&M
what it takes to stand up lead Texas A&M
what it takes to stand up lead Texas A&M and the United States to zero
and the United States to zero
and the United States to zero preventable deaths from massive bleeding
preventable deaths from massive bleeding
preventable deaths from massive bleeding thank
thank
thank [Applause]
[Applause]
[Applause] [Music]
[Music]
[Music] you
”
Be First to Comment