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I heard the "stick and get stuck" part of CLS was removed from BOLC. Anyone know if this is true? That was my favorite part - it was a blood bath. So many people didn't set their IV caps after placing the needle that there was blood everywhere. I remember 2 females who were afraid of blood who refused to even go close to the tables.
Posted >1 y ago
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Even with it being out of the formal POI, it can still be incorporated into training (pending the approval from the BN PA).
To call someone a "tourniquet monkey" implies that, like the geico commercials, it's so easy a cave man can do it. We know that the tourniquet saves lives when used at the right time in the right way. That seemingly simple application of the tourniquet is no different than the training hours spent on how to perform SPORTS (or POPS if you are so inclined). We train to be able to do things at combat speed. That blood soaked tourniquet being applied by shaking, sweaty hands on a mangled stump that doesn't want to cooperate is no simple feat.
All in all, I'd have to say that constant, consistent, competent training is what saves lives. The details may change after years of research, but the principle is the same.
To call someone a "tourniquet monkey" implies that, like the geico commercials, it's so easy a cave man can do it. We know that the tourniquet saves lives when used at the right time in the right way. That seemingly simple application of the tourniquet is no different than the training hours spent on how to perform SPORTS (or POPS if you are so inclined). We train to be able to do things at combat speed. That blood soaked tourniquet being applied by shaking, sweaty hands on a mangled stump that doesn't want to cooperate is no simple feat.
All in all, I'd have to say that constant, consistent, competent training is what saves lives. The details may change after years of research, but the principle is the same.
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Don't know, but can't see why they would remove that. That is a key aspect of being a CLS.
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MAJ (Join to see)
Gentlemen, pushing IV fluids for all trauma patients has been removed since the advent of TCCC. It is not only a bad idea but it is usually more harm then good. Those who have no concept of Combat Medicine and spend entirely too much time thinking of cookie cutter remedies (everyone gets an IV) should leave to combat casualty care to those of us who do it for a living. This has been removed from the protocol since 2004 and is not encouraged on any trauma treatment any more. TCCC and CoTCCC guidelines are available online or feel free to contact me directly at Brigade Combat Team Trauma Training
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MAJ (Join to see)
Ugh....my autocorrect slaughtered that. Trauma patients, not tRayman. TCCC and CoTCCC guidelines not TV adn Cotton
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As a nurse and former Combat medic, I can see a couple things going along with this decission (some have been mentioned above). Here are my PERSONAL THOUGHTS:
1. Focus on IV instead of lifesaving measures such as airway
2. Over hydration in situations that do not need massive fluid bolus (lots of talk about popping clots, BUT I would say a bigger risk is dilution of the oxygen carrying blood to levels that are ineffective in carrying enough oxygen...remember IV fluids do not carry oxygen).
3. Any IV started ESPECIALLY in a classroom setting is un-necessarily increasing the risk of infection.
4. How many of you folks have carried full ruck (stupid question you may say).... Full Ruck is what 60? 80 pounds? Remember, water is 8 pounds per gallon. 4 IV bags would make appriximately 1 gallon. in a true massive fluid loss situation, 4 bags is nothing....that means that SOMEONE is carrying all their gear and at least 8+ pounds of IV Fluids.
5. medivac systems have improved greatly over time. Keep the casualty alive, let the medics push fluids and give meds.
6. for training sessions now, if they decide to continue keeping IV training as part of it, there are SIM people that will allow every aspect of treatment to include IV's to be placed without unnecessary risk. Not to mention, IV starting is an art...if you do not practice it regularly, do you really think you will hit an IV under battlefield stress? I think not.
7. Many medics now carry the Inter-Osseous system. Placed in the sternum or the Tibia, faster, more secure, and and very effective. Not as risky to place as the old IV while on the battle field.
Just my thoughts....not sure if it is the real reason or not.
1. Focus on IV instead of lifesaving measures such as airway
2. Over hydration in situations that do not need massive fluid bolus (lots of talk about popping clots, BUT I would say a bigger risk is dilution of the oxygen carrying blood to levels that are ineffective in carrying enough oxygen...remember IV fluids do not carry oxygen).
3. Any IV started ESPECIALLY in a classroom setting is un-necessarily increasing the risk of infection.
4. How many of you folks have carried full ruck (stupid question you may say).... Full Ruck is what 60? 80 pounds? Remember, water is 8 pounds per gallon. 4 IV bags would make appriximately 1 gallon. in a true massive fluid loss situation, 4 bags is nothing....that means that SOMEONE is carrying all their gear and at least 8+ pounds of IV Fluids.
5. medivac systems have improved greatly over time. Keep the casualty alive, let the medics push fluids and give meds.
6. for training sessions now, if they decide to continue keeping IV training as part of it, there are SIM people that will allow every aspect of treatment to include IV's to be placed without unnecessary risk. Not to mention, IV starting is an art...if you do not practice it regularly, do you really think you will hit an IV under battlefield stress? I think not.
7. Many medics now carry the Inter-Osseous system. Placed in the sternum or the Tibia, faster, more secure, and and very effective. Not as risky to place as the old IV while on the battle field.
Just my thoughts....not sure if it is the real reason or not.
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LTC Paul Labrador
MAJ Nelson, as for #2, it is actually both. When you hemodilute the blood you not only create artificially induced anemia but you also dilute everything else as well to include clotting factors. With the decreased clotting factors coupled with increased blood pressure, hemostatsis through clotting becomes a huge issue.
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CW3 Kevin Storm
Not to mention that the selection of the wrong fluid can create problems that can't be corrected in a field situation.
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