Originally posted by Knucklehead
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"Let us be clear about three facts. First, all battles and all wars are won in the end by the infantryman. Secondly, the infantryman always bears the brunt. His casualties are heavier, he suffers greater extremes of discomfort and fatigue than the other arms. Thirdly, the art of the infantryman is less stereotyped and far harder to acquire in modern war than that of any other arm." ------- Field Marshall Wavell, April 1945.
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Originally posted by Knucklehead View PostCasualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
Beyond your mum telling how great you are
No playstation for more than 4 hours
Spending more than 5 minutes in direct sunlight
Having a normal conversation with " actual" people
Wearing a uniform that doesnt belong to thunderbirds
Take your time knucklehead..alot to take inLast edited by knocker; 22 May 2011, 16:46.Every man thinks meanly of himself for not having been a soldier - Samuel Johnson
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Originally posted by sofa View PostIs it the case that when a doctor discovers that a tourniquet has been used
he will amputate due to the danger of gangrene setting in. ????
When a tourniquet is applied, then blood is not being pumped to the limb.
Now for the science bit (Biology 101) Blood carries Oxygen (O2) to the cells, and carries away the waste products of cellular respiration. When a tourniquet is applied, this can't happen.
After a relatively short time, the build up of waste products, both from normal cellular respiration and the enzymes etc released by the damaged tissues can be such that when the tourniquet is released the flow of these back into the body can result in organ damage, with acute renal failure a major risk.
This is akin to Crush Syndrome, (and the reason why release of crushed limbs has to be carried out within a certain time-scale, after which amputation on-site is considered an option, as it's easier to live without an arm than kidneys.)
Releasing the tourniquet regularly will allow the re-perfusion of the limb before these toxins build up to dangerous levels.
Gangrene itself is a relatively slow process, with the limb taking a few days to turn green and smelly - think how long a piece of meat can last before it starts to rot - certainly not within two hours.
The other big risk from a tourniquet is that if incorrectly applied, they can cause increased bleeding. Veins are much thinner walled (and closer to the surface) than arteries. If a tourniquet is applied that closes the veins, but does not close the arteries, then blood is getting pumped into the limb, but can't get out - except through the hole!
There is a risk of further significant trauma to the soft tissues of the limb if a tourniquet is applied too tight as well.
They are a useful tool, but don't be too gung-ho about their use. Direct pressure on a wound is very effective for closing it off. Indirect pressure on a pressure-point is also very effective, I've used both to good effect (mainly in a clinical environment, I will admit), and whilst tourniquets are at times necessary. don't forget that direct pressure and elevation makes a huge difference. A limb that is below the heart will bleed like buggary, as soon as it is above the heart it decreases significantly.
(Sorry if any of the above is teaching anyone to suck eggs. If anyone wants me to re-write it using lots of big words like "Traumatic Rhabdomyolysis" and "Hyperkalaemia", then I'll pull out my old textbooks and start again! )'He died who loved to live,' they'll say,
'Unselfishly so we might have today!'
Like hell! He fought because he had to fight;
He died that's all. It was his unlucky night.
http://www.salamanderoasis.org/poems...nnis/luck.html
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Originally posted by Knucklehead View PostCasualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
Basic first aid isn't good enough. Well, in most professional armies it's not.
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Excellent post Flamingo, truly excellent. I'd always wondered down through the years of first aid courses the whys and why nots of tourniquets.
Surely from Iraq and the 'Stan over the last decade there must be a serious update to the manuals and courses - this is what works in general ( what the rifle section must change and what we must change in basic training ) , and what we need to carry on us."Are they trying to shoot down the other drone? "
"No, they're trying to fly the tank"
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Originally posted by Knucklehead View PostYour comments were expected. Have a nice day and keep waving the Blue flag.
Now.Where were we?
Good point Flamingo about elevating the limb?What do you if the limb has been blasted off?"Let us be clear about three facts. First, all battles and all wars are won in the end by the infantryman. Secondly, the infantryman always bears the brunt. His casualties are heavier, he suffers greater extremes of discomfort and fatigue than the other arms. Thirdly, the art of the infantryman is less stereotyped and far harder to acquire in modern war than that of any other arm." ------- Field Marshall Wavell, April 1945.
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Originally posted by apod View PostGood point Flamingo about elevating the limb?What do you if the limb has been blasted off?
Seriously, what Rod said, elevate the stump.
With a traumatic amputation, the risk of Crush Syndrome is reduced, as the limb is not there to produce the toxins. Put the tourniquet on as close to the end of the limb as possible, and don't get too hung up about the release times, it's less important in these cases.
Another thing to remember about tourniquets is to apply them as close to the wound as possible, and also, don't use anything too narrow if improvising. Use a belt of a bandage rather than para-cord, the wider the pressure is spread the better.
Of course, if available (and the injured site allows access), the best tourniquet is a BP cuff, as it is designed to cut off blood, and can be released and re-inflated easily.'He died who loved to live,' they'll say,
'Unselfishly so we might have today!'
Like hell! He fought because he had to fight;
He died that's all. It was his unlucky night.
http://www.salamanderoasis.org/poems...nnis/luck.html
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Originally posted by trellheim View PostExcellent post Flamingo, truly excellent. I'd always wondered down through the years of first aid courses the whys and why nots of tourniquets.
Originally posted by trellheim View PostSurely from Iraq and the 'Stan over the last decade there must be a serious update to the manuals and courses - this is what works in general ( what the rifle section must change and what we must change in basic training ) , and what we need to carry on us.'He died who loved to live,' they'll say,
'Unselfishly so we might have today!'
Like hell! He fought because he had to fight;
He died that's all. It was his unlucky night.
http://www.salamanderoasis.org/poems...nnis/luck.html
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Excellent posts Flamingo.Such a terrible,terrible pity that its gonna take Irish soldiers getting maimed by IED's overseas before we catch up with the rest of our PFP partners in terms of Trauma management training for our non medical personel."Let us be clear about three facts. First, all battles and all wars are won in the end by the infantryman. Secondly, the infantryman always bears the brunt. His casualties are heavier, he suffers greater extremes of discomfort and fatigue than the other arms. Thirdly, the art of the infantryman is less stereotyped and far harder to acquire in modern war than that of any other arm." ------- Field Marshall Wavell, April 1945.
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Originally posted by apod View PostExcellent posts Flamingo.Such a terrible,terrible pity that its gonna take Irish soldiers getting maimed by IED's overseas before we catch up with the rest of our PFP partners in terms of Trauma management training for our non medical personel.
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Originally posted by Flamingo View PostSorry, just seen this post. (Bear with me, I'm trying to remember this from a few years back, it's not the day job any more - if I am not using the most technical terms, forgive me)
When a tourniquet is applied, then blood is not being pumped to the limb.
Now for the science bit (Biology 101) Blood carries Oxygen (O2) to the cells, and carries away the waste products of cellular respiration. When a tourniquet is applied, this can't happen.
After a relatively short time, the build up of waste products, both from normal cellular respiration and the enzymes etc released by the damaged tissues can be such that when the tourniquet is released the flow of these back into the body can result in organ damage, with acute renal failure a major risk.
This is akin to Crush Syndrome, (and the reason why release of crushed limbs has to be carried out within a certain time-scale, after which amputation on-site is considered an option, as it's easier to live without an arm than kidneys.)
Releasing the tourniquet regularly will allow the re-perfusion of the limb before these toxins build up to dangerous levels.
Gangrene itself is a relatively slow process, with the limb taking a few days to turn green and smelly - think how long a piece of meat can last before it starts to rot - certainly not within two hours.
The other big risk from a tourniquet is that if incorrectly applied, they can cause increased bleeding. Veins are much thinner walled (and closer to the surface) than arteries. If a tourniquet is applied that closes the veins, but does not close the arteries, then blood is getting pumped into the limb, but can't get out - except through the hole!
There is a risk of further significant trauma to the soft tissues of the limb if a tourniquet is applied too tight as well.
They are a useful tool, but don't be too gung-ho about their use. Direct pressure on a wound is very effective for closing it off. Indirect pressure on a pressure-point is also very effective, I've used both to good effect (mainly in a clinical environment, I will admit), and whilst tourniquets are at times necessary. don't forget that direct pressure and elevation makes a huge difference. A limb that is below the heart will bleed like buggary, as soon as it is above the heart it decreases significantly.
(Sorry if any of the above is teaching anyone to suck eggs. If anyone wants me to re-write it using lots of big words like "Traumatic Rhabdomyolysis" and "Hyperkalaemia", then I'll pull out my old textbooks and start again! )
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Just learnt today that there will soon be an annual Medical TOET to be passed along with the usual APWT's ,IT's etc.
Wonder what it will include?CPR for definete."Let us be clear about three facts. First, all battles and all wars are won in the end by the infantryman. Secondly, the infantryman always bears the brunt. His casualties are heavier, he suffers greater extremes of discomfort and fatigue than the other arms. Thirdly, the art of the infantryman is less stereotyped and far harder to acquire in modern war than that of any other arm." ------- Field Marshall Wavell, April 1945.
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