There has been an increase in the carry of emergency medical gear among concealed carriers and other people invested in personal preparedness. Fatality due to severe hemorrhage is a leading cause of death in accidents and violence, and medical tools designed to stop or slow such bleeding save lives. The primary tools in this regard are tourniquets, packing gauze, pressure dressings, and chest seals. The tourniquet, in particular, gets a lot of attention, even though it only serves a purpose for injuries inflicted on the limbs. Therefore, many emergency medical professionals point out that the fascination with the tourniquet may be somewhat overemphasized since, again, it is a tool only suited for injury sustained on the extremities.
Carrying a full trauma kit in the vehicle, in a backpack, etc.…, that contains all four referenced bleeding control devices is sound. However, carrying all four devices on-body becomes more challenging. A common means of doing so is the use of an ankle cuff that can accommodate these tools, but if not utilizing such an ankle cuff, carrying all the necessary medical devices becomes difficult. Therefore, what medical device should take priority if limited in what can be carried on-person?
Why Carry a Tourniquet?
There is a reasonable argument to be made that if you only carry one medical device, it should be a tourniquet. Yes, the tourniquet only serves to mitigate severe bleeding on limbs, but the nature of accidents suggests that a significant percentage of life-threatening bleeding occurs from the limbs. In the concealed carry community, we tend to get hung up on violence and the possible aftermath. Chest seals, for example, are the field expedient to treat chest puncture wounds. Therefore, if thinking only about gunfights, carrying chest seals seems to make good sense. Certainly, having chest seals in a full trauma kit should be obvious. However, if we carry a single medical device on-person, consider the overall danger and the causes.
How many people do you know that have been shot in the chest? Compare that with how many people you know who have crashed through plate glass windows, or been cut on the arms or legs by machinery, etc.… Accidents with machines tend to injure the limbs. Such accidents are far more common than getting shot. Therefore, if considering the totality of this threat, limb injury is pronounced.
Also of concern is the ability to improvise medical gear or not. Junctional wounds can be packed with a T-shirt, and a pressure dressing can be improvised, perhaps not well, but it can be done. Improvised tourniquets, however, prove notoriously ineffective. Therefore, the tourniquet is the one major hemorrhage control device that is difficult to improvise to any extent in the field. When we combine the large percentage of wounds being to extremities with the fact that the tourniquet is very hard to improvise, the decision to carry at least a tourniquet on-body becomes quite sound.
Carrying a Tourniquet On-Body
While carrying tourniquets and other medical gear in a backpack or bag is fairly easy, carrying it on-person requires some consideration. For a tourniquet to be truly effective, it needs to have a windlass, which is the small stick that is used to tighten it after initial application further. It is wise only to use tourniquets approved by the Committee of Tactical Combat Casualty Care, and right now, there are several. The most widely used tourniquets and the most proven in combat conditions are the CAT (Combat Application Tourniquet) and the SOFT-T Wide tourniquet. This author finds no reason to look beyond these two tried-and-true alternatives for simplicity’s sake.
Among those who train in emergency bleeding control, these are the two most commonly used tourniquets, and each individual tends to prefer one or the other. While the CAT and SOFT-T Wide are both proven to be sound, the SOFT-T is easier to carry on-body because it can be flat-folded down to a small size. If you prefer the CAT, that is fine, but if you are looking to embrace on-body carry of a tourniquet for the first time, be warned, the SOFT-T is much easier to carry due to the smaller profile.
Besides using an ankle cuff, which simply does not work for many people, there are a number of ways to carry at least a tourniquet on your person. The SOFT-T Wide, when flat folded, is small enough to fit in the hip or back pocket of all but the tightest jeans. There are also inside-the-waistband pouches specifically designed for carrying a tourniquet. A flat-folded SOFT-T is about the size of a magazine if carried inside-the-waistband, and about the size of a small phone if carried in the pocket. Whether or not dedicating such pocket or waistband real estate is worth it is up to the individual. However, this author proposes that a tourniquet is more likely to be needed on any given day than a spare magazine (and I also carry a spare magazine most of the time).
Deploying a Tourniquet
No matter where on your body you carry the tourniquet, consider how easy it is to access and deploy. You want to be able to access and deploy the tourniquet with a single hand. The most difficult possible tourniquet application is to apply it to yourself if one of your arms is the injured limb. Needless to say, it is much harder to apply a tourniquet with a single hand. Consider this when thinking about how to carry the device. For example, having a few rubber bands around the tourniquet might keep it nice and neatly folded, but can you get those rubber bands off of it single-handed, while bleeding to death? Like your pistol, the tourniquet does you no good in an emergency if you can’t get it out and into action in time.
As should go without saying, you owe it to yourself and those you care for to seek training in traumatic bleeding control. A basic Stop the Bleed class is a good start, as these short classes typically address tourniquet application and wound packing. (Editor’s Note: There’s also a free Stop the Bleed Course online .) While you can find a lot of information online, there is no substitute for practicing these skills with an experienced instructor watching and correcting your technique. Once trained on this skill, you should periodically practice the tourniquet application. Be sure to use a dedicated training tourniquet for practice, not the one you carry.
Carrying medical gear, particularly a tourniquet, on-body makes good sense; when such a tool is necessary, you have no time to run to a different location to access it. While carrying an entire trauma kit on your person might prove difficult to do regularly, a tourniquet alone can be carried quite readily. There is good reason to prioritize this particular piece of gear.