Army News, news from Iraq, - Army Times

The Army is sending about 170,000 Combat Application Tourniquets overseas for Central Command to issue to every soldier serving in combat areas.

The move marks a major shift in the Army’s approach to controlling bleeding on the battlefield. Up to now, soldiers have been taught to use a pressure dressing first because a tourniquet can damage the limb and lead to amputation.

Compression and direct pressure are still preferred if possible, but soldiers are being taught to use a tourniquet to stop arterial bleeding while under enemy fire, said Sgt. 1st Class Christian Reid, combat developer at the Army Medical Department Center and School.

“If you are under effective hostile fire, you really don’t have the time to take the other steps to control bleeding,” he said.

The Combat Application Tourniquet is just one of the new items in the Army’s Improved first-aid kit, that’s being prepared for issue to soldiers going to Iraq and Afghanistan.

The Army medical community began work on the kit in September 2003 and a pilot program was conducted at Fort Knox, Ky., last October to work out training procedures. Gen. Kevin Byrnes, commander of the Army’s Training and Doctrine Command, approved the training in late January. Maj. Gen. Martinez Lopez, commander of Army Medical Research and Material Command, approved the new first-aid kit March 24 for issue to all soldiers.

The kit includes a new trauma dressing, based on the Israeli bandage, which features a large sterile pad attached to an elastic wrap-style bandage. A clamp on the elastic bandage allows the soldier to apply compression to the wound to help stop bleeding. A plastic clip at the end of the elastic bandage allows it to be secured.

The kit also includes 4 yards of elastic gauze, a 2-inch roll of medical tape, a special rubber tube known as a nasopharyngeal adjunct to aid oxygen flow to soldiers with facial injuries and two pairs of exam gloves.

The kit will be carried in the same pouch used by soldiers to carry 100-round belts of ammunition for the M249 squad automatic weapon.

A key concern in designing the kit was that it should be as light as possible.

“It roughs out at 1.2 pounds — that was a significant consideration in the development of this kit,” Reid said.

The plan is to issue the kits through the Rapid Fielding Initiative. At first, they won’t include tourniquets, because those are being fielded now. Soldiers can apply the new tourniquet with one hand if necessary.

The device features a bar that soldiers use to crank down pressure to stop the blood flow to a traumatic wound on an arm or leg. Once bleeding has stopped, the bar can be locked in place. A Velcro strap is applied for further securing during casualty evacuation.

Tourniquets are designed to cut off blood circulation completely to an injured arm or leg. They stop massive blood loss, but can also cause an appendage to be lost if left on too long.

Up to now, medics have carried tourniquets; soldiers were trained only to fashion them from belts and strips of cloth in an emergency. But advances in battlefield medicine teamed with faster casualty evacuation since the 1991 Persian Gulf War persuaded the Army to recognize that tourniquets can be a safe first choice in some cases for preventing soldiers from bleeding to death.

Down but not out

“Our post-combat surveys tell us that a lot of soldiers continue to fight after being wounded,” said Col. Charles Durr, director for combat development for the Army’s Infantry Center at Fort Benning, Ga. “What you don’t want to do is have a guy bleed out” before the situation is under control and the soldier can be evacuated.

Reid also stressed the importance of ensuring that soldiers are equipped with the same kit instead of a mix of off-the-shelf medical gear.