Multipitch first aid kit

Jay Dee wrote: 15 seconds from diagnosis. Certain hemorrhaging will only be stopped in time to save if you're there and can apply within a minute and a half. Some can take longer to apply but still keep blood in enough to save. Not all bleed outs are quick. Some take a couple of hours instead on minutes. 

Could most or all 2 hour bleed out external wounds be controlled with clotting bandages?

That all sounds pretty suspect to me. I took a WFR class and they reiterated over and over that WFRs aren't qualified to diagnose anything, so "15 seconds from diagnosis" sounds like pretty unlikely language.

They also explained that if seconds make the difference between life and death, the person is probably dead in the backcountry anyway. It seems really silly to say "sure, it might take you 5 minutes to get to the person and diagnose them, but once you do that, suddenly you're on a 15 second deadline".

All that is to say, if this is the official standard of a WFR course, I'd like to see some documentation of that fact.

I do carry an Israeli bandage and QuikClot in my first aid kit, but that's because I bring my first-aid kit out for activities other than climbing.

Bill Kirby wrote: The shirt off your back and a roll of tape

Edit: First aid knowledge 

This

climber pat wrote:

Could most or all 2 hour bleed out external wounds be controlled with clotting bandages?

It is recommended to TQ extremity wounds and pack junctional wounds such as pelvic region,  shoulder area, or neck. Packing a large extremity wound would take a lot of packing material. More than anyone would carry climbing or backpacking for certain wounds. Even with Celox or Quickclot packing. You would need to produce copious amounts of bandage swell so the TQ would be more logical anyways. 

David K wrote: That all sounds pretty suspect to me. I took a WFR class and they reiterated over and over that WFRs aren't qualified to diagnose anything, so "15 seconds from diagnosis" sounds like pretty unlikely language.

They also explained that if seconds make the difference between life and death, the person is probably dead in the backcountry anyway. It seems really silly to say "sure, it might take you 5 minutes to get to the person and diagnose them, but once you do that, suddenly you're on a 15 second deadline".

All that is to say, if this is the official standard of a WFR course, I'd like to see some documentation of that fact.

I do carry an Israeli bandage and QuikClot in my first aid kit, but that's because I bring my first-aid kit out for activities other than climbing.

I don't know where the 15 seconds rule came from but I do know that if someone is suffering from a large extremity bleed and a TQ is properly applied then they can live for hours and not die from a bleed that could kill within an hour. Keep blood in and prevent shock. One can live for a lot longer than you'd think. 

There seems to be a lot who, for some reason, don't like the idea of a tourniquet but I don't think anyone's given a con to carrying one. Anyone have a reason not to bring one? 

Jay Dee wrote:

I don't know where the 15 seconds rule came from but I do know that if someone is suffering from a large extremity bleed and a TQ is properly applied then they can live for hours and not die from a bleed that could kill within an hour. Keep blood in and prevent shock. One can live for a lot longer than you'd think. 

Okay, but I don't think anyone is arguing against the effectiveness of tourniquets. The argument is that a purpose-made tourniquet isn't better than a sling and a carabiner; that might take longer than 15 seconds, but I always have a sling and carabiner on me when multipitching.

David K wrote:

Okay, but I don't think anyone is arguing against the effectiveness of tourniquets. The argument is that a purpose-made tourniquet isn't better than a sling and a carabiner; that might take longer than 15 seconds, but I always have a sling and carabiner on me when multipitching.

That's kinda my thought, If the 15 seconds tq is what is making the difference; they're dead anyways (in my mind). I bet i could make a half decent one with a sling or two and a biner in around a minute. 

Jay Dee wrote: There seems to be a lot who, for some reason, don't like the idea of a tourniquet but I don't think anyone's given a con to carrying one. Anyone have a reason not to bring one? 

There is only so much stuff I will carry up a climb and I don't think it is worthwhile to carry a tourniquet which I will almost certainly not use.  So far only 2 examples have been found is 50ish years of climbing accidents where a tourniquet was helpful.

I once climbed with someone who sport climbed at least 2 number grades harder than me.  We went trad climbing and he insisted on carrying his first aid pack and barely could climb 2 number grades below my grade. The weight and bulk matters.

To be clear, I don’t teach WFR, and the 15” standard is self application, which means that you must have the TQ on your person.

I know there are more accidents where a TQ has been applied or was necessary, but I’m not going to try to track them down.

I don’t care who carries a TQ, but when someone asks what they should add to their FA kit, I offered my opinion.  Most first aid kits are too much to climb with and not worth their weight (great to have in your pack).
You will NOT be able to improvise a TQ if a TQ is actually needed; a sling is too narrow. You may get full blood occlusion but you’re probably going to do major nerve/tissue damage, and unless it’s already a full amputation (ie. blast injury) this will greatly damage the limb recovery. 
If anyone actually plans to carry a TQ, it’s imperative to learn how to use it or you might as well leave it at home. 

ikmortu wrote: To be clear, I don’t teach WFR, and the 15” standard is self application, which means that you must have the TQ on your person.

I don’t care who carries a TQ, but when someone asks what they should add to their FA kit, I offered my opinion.  Most first aid kits are too much to climb with and not worth their weight (great to have in your pack).

So which is it? Is the tourniquet in your first aid pack on the ground, or is it on your person, where you can self-apply it in 15 seconds? Keep in mind, I've been on multipitch where my pack on the ground was 2-3 hours away for a completely healthy team.

Does the first responder course cover a lot of self-treatment standards that don't apply to treating patients other than yourself? That wasn't included in the wilderness first responder (WFR) course. ;)

You will NOT be able to improvise a TQ if a TQ is actually needed; a sling is too narrow. You may get full blood occlusion but you’re probably going to do major nerve/tissue damage, and unless it’s already a full amputation (ie. blast injury) this will greatly damage the limb recovery. 

Even if you can't figure out how to widen the surface area of the sling with clothing, it seems to me like preventing the person from bleeding to death is still a pretty big success for the improvised tourniquet.

Jay Dee wrote: There seems to be a lot who, for some reason, don't like the idea of a tourniquet but I don't think anyone's given a con to carrying one. Anyone have a reason not to bring one? 

Can you tell the difference between venous and arterial hemorrhage? Can you recognize the signs and symptoms of shock? Do you have the means to measure a blood pressure or heart rate? Replace lost fluids? Do you know where to apply the tourniquet and how to do it properly? Do you even need one to apply one? Consider that two tourniquets may be required?

Don't bring a tourniquet if you have not been properly trained in the indications for the use of one. There are benefits and risks. Does one out weight the other and can you tell the difference?

That said, I carry one in my kit. 

Peter Blank wrote: My first aid kit is a pack of quick clot in my pocket and a bandana on my head.  Most anything life threatening that you have any chance at remedying on the side of a cliff can be addressed with these.  Most everything else is fluff.  I do also carry a bit of tat (cordlette), a knife, and two stoppers (mostly for deep cam retrieval).  

I climb with this guy. He also carries a Glock for anything he can't fix with quick clot

Jay Dee wrote:

It is recommended to TQ extremity wounds and pack junctional wounds such as pelvic region,  shoulder area, or neck. Packing a large extremity wound would take a lot of packing material. More than anyone would carry climbing or backpacking for certain wounds. Even with Celox or Quickclot packing. You would need to produce copious amounts of bandage swell so the TQ would be more logical anyways. 

How does one get such a wound climbing?  It appears from my reading an Israeli  bandage is what is really needed to pack a wound.  Israeli bandages were invented to treat gun shoot wounds for the military. 

This goes back to an earlier post where very few accidents resulted in death by blood loss

Edit.  I see the how such a wound is likely from the previous post . :) :(

David K wrote: So which is it? Is the tourniquet in your first aid pack on the ground, or is it on your person, where you can self-apply it in 15 seconds? Keep in mind, I've been on multipitch where my pack on the ground was 2-3 hours away for a completely healthy team.

Does the first responder course cover a lot of self-treatment standards that don't apply to treating patients other than yourself? That wasn't included in the wilderness first responder (WFR) course. ;)

Even if you can't figure out how to widen the surface area of the sling with clothing, it seems to me like preventing the person from bleeding to death is still a pretty big success for the improvised tourniquet.

My TQ is in my pocket and the remainder of my kit is in my pack, and I leave the pack on the ground for single pitch climbs.

The first responder course (tries to) cover everything from self-treatment to mass casualty.
Any prevention of death is a success and an improvised TQ may be effective in controlling some blood loss, BUT when seconds count and you truly need a TQ improvisation will fail.  
Also, Israeli Battle Dressings (IBDs) we’re designed for treating GSW, but more as a compression dressing. Newer designs of the IBDs do include material for wound packing but not all.  I carry a 4” IBD in my pack which includes material for wound packing. I highly recommend IBDs they can do anything from compression to sling to splinting. 

Here’s an unfortunate accident illustrating the ineffectiveness of improvised tourniquets.

A hiker cut his leg badly and tried to improvise a tourniquet with his belt; it didn’t work and he died as a result.

www.miningjournal.net/news/front-page-news/2019/09/hiker-found-deceased/

ikmortu wrote: Here’s an unfortunate accident illustrating the ineffectiveness of improvised tourniquets.

A hiker cut his leg badly and tried to improvise a tourniquet with his belt; it didn’t work and he died as a result.

www.miningjournal.net/news/front-page-news/2019/09/hiker-found-deceased/

the article mentions nothing about dying as a result of blood loss. Could have easily died from exposure. let's not assume until the official report is out...

You’re right, that article doesn’t list the cause of death as blood loss but I chose it because it indicates that the TQ was improvised. The police report does list the cause of death as blood loss and not exposure. 

curt86iroc wrote:

the article mentions nothing about dying as a result of blood loss. Could have easily died from exposure. let's not assume until the official report is out...

Other articles claim death from injury, not exposure but who knows. It's up to you what you want to lug around. As someone stated, knowledge is more useful than a tool. Get the knowledge, then you won't have to question what you need. 

If you can carry an iphone, you can carry a Tourniquet. Making a tourniquet from sling requires two slings and two carabiners , twist both separately then put a stick between the two carabiners as a windless, good luck doing that one handed. Also not all injuries are climbers, a lot of the injuries seen are hikers/tourist and the drive to and from. Stay safe.

Just to add to the list I now keep a $19 NAR quick litter under the seat of my car for those broken/sprained ankles.

  narescue.com/all-products/e…;