r/TacticalMedicine • u/PerfectEqual3115 • 15d ago
Gear/IFAK Which ETQ do you recommend? Regular or wide?
Which tourniquet from Snakestaff Systems do you recommend? The regular or the wide one? I'm torn.
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u/JonEMTP 15d ago
Neither? Not a CoTCCC recommended tourniquet, and there’s not really compelling evidence that they work better than the current crop that are.
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u/PerfectEqual3115 15d ago
What neither?
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u/Then-Bread-3995 15d ago
SOFTT-W flat folded
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u/ChrisWhiteWolf 15d ago
This is the right answer. Got 1 of them alongside a packet of QuikClot and a pair of gloves inside of a ziplock bag that's always in my pocket.
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u/VXMerlinXV RN 15d ago
Neither, there are enough tourniquets with adequate research conducted regarding their use that I don’t need JV equipment.
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u/always_gone 15d ago
The wider the TQ the more effective it is in stopping bleeding with the same amount of force as a narrower TQ. This is why the RATS is garbage.
For whatever reason you seem resistant to the CAT because it’s slightly larger, despite it being the industry standard. The size difference is minimal and I would be so pissed if I bled out because my homie couldn’t be bothered to make one more inch of room in his pocket.
If you’re insistent on going with a low pro option go with the SWAT-T. Never used one, but I imagine they pack pretty small and had always read they were actually very effective (although I haven’t read about them in several years).
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u/NopeRope13 15d ago
Wide. I’d rather have more and not need it, than need it and not have it
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u/OppressedGamer_69 15d ago
Total noob here but can I ask what the difference between a wide and narrow one is? Like what is the advantage of the wider style?
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u/VXMerlinXV RN 15d ago
There are industry accepted TQ strap width standards that the standard ETQ doesn’t meet. There’s an argument to be made that the wide should be the standard product and the standard should be pulled from market.
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u/PerfectEqual3115 14d ago
But the Wide Tourniquet from Snakestaff Systems has the same width as the CAT.
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u/VXMerlinXV RN 13d ago
Correct. The Wide model is the requisite 1.5” width. The standard model is 1”, which does not meet the ANSI/ISEA z308.1 2021 update to specifications for an arterial tourniquet.
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u/PerfectEqual3115 15d ago
Thank you 👋🏼
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u/NopeRope13 15d ago
If this helps: at work I carry a sharpie for many reasons. One is TQ application. I now can write the time of placement on you and also mark pulse points. Or rather lack of pulse points since I placed a TQ
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u/Mundane_Elevator3455 15d ago
I have both, the regular ended up being smaller than I expected, but not impractical. The regular is pocket size. If you’re only getting one or the other, get the “wide”. I have plenty of CAT TQ’s I keep in my kit, and the wide is noticeably smaller in length than them when I run it on my belt.
TLDR: Pocket EDC - Regular / Duty use - Wide
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u/rattler8888 Medic/Corpsman 15d ago
I was taught tourniquets need to be 2" or wider in order to not cause soft tissue crush injuries. Then they turned around and taught us how to improvise one with cravats and sticks. So, my takeaway was, stop the kool-aid leaking first, worry about the rest later, that tourniquet is supposed to be reduced to a pressure dressing later on anyway.
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u/PerfectEqual3115 15d ago
Yes, you're right. But the wide version from Snakestaff Systems is just as wide as the CAT.
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u/ChemicalType3415 15d ago
There was several recommendations by COTCCC to refine the snack staff TQ
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u/PerfectEqual3115 15d ago
You can read about the improvements to the Gen. 2 on Snakestaff Systems' website.
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u/TovarichBravo EMS 15d ago
CAT, SWAT T, Israeli bandages and combat gauze. I recommend having all of these things on you for extanguination, but not a bullshit off brand tourniquet
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u/struppig_taucher 15d ago
The SWAT-T is not recommended by the CoTCCC for TQ use on humans due to its unrealibility. This is why it is one of the few TQs recommended for TECC-K9 care. Also, combat gauze is not even the best gauze on the market anymore since more than half a decade. Chitosan works better in hypothermic patients than kaolin and costs less than combat gauze (ChitoGauze in this case). New, and old studies out of 2010 have proven this so.
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u/TovarichBravo EMS 15d ago
I love folks like you, truly.
Here's the thing, you want the latest and greatest high dollar shit so it can sit in your LARP gear and never get used, and you'll completely discount the items that virtually every EMS service in the world uses daily to save lives. Tell me more about how the shit I've saved hundreds of lives with doesn't work or "isn't the best"
The best gear is what you have available to you in the moment that gets the job done.
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u/struppig_taucher 15d ago edited 15d ago
Yes, the best gear is what you have on your hands, but hear me out.
Though, chitosan has been continuesly researched on about for over a decade in both swine AND human review. What happened? Chitosan outperformed kaolin by not a marginal basis, but on a noticable basis. This is basic science, not the old saying 'if it works, don't touch it.'. I can say the same with plain normal gauze - gauze has been used since centuries. There is a picture of Achilles tending Patroclus with a bandage, looking like gauze, from 500 BC. Is gauze better than hemostatic gauze? Absolutely not. Will it still work? Yes. Only because you use your equipment on a daily basis, and save lifes with it on a daily basis then it does not mean it is better than other stuff that has been evidentily proven to be better than your equipment. The same goes to vaseline gauze. It has likely saved lifes in the past, but chest seals are obviously better. Chitosan evidentily works on coagulopathic patients way better than kaolin, achieves the same, if not a better basis of hemostasis than kaolin, is hypoallergenic (the already low majority of documented allergic reactions on chitosan are more likely caused by cross contamination or remaining shellfish proteins than allergic reactions explicitely caused by chitosan) cheaper than kaolin-based hemostatic gauze and recommended by the CoTCCC & German S3 Guideline for polytrauma-management. Is it not enough for you that chitosan evidentily works better on coagulopathic patients, even on hypothermia induced coagulopathic patients, than kaolin? Kaolin has been long outdated by chitosan, but the majority of the armies stick to QuikClot due to the already existing contracts.
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u/TovarichBravo EMS 14d ago
You are trying to find a solution to a problem that simply doesn't exist, and that's why it doesn't gain traction. When used correctly, quick clot works. When used correctly, CATs work. Attempting to reinvent the wheel will never work, especially with EMS. No service is just going to drop CATs and start buying different shit without years and years of evidence based data if CATs are currently working for the task they are designated for.
So again I will say, I get it. You want to be edgy. You want to be niche. You want to be different. The rest of us are driving around on wheels that work just fine and have no desire to reinvent the shit. No desire to re-educate all of our people, all of the local fire and and LEOs that show up on scenes with us and also use our stock. The emergency Departments that we are bringing patients to also have to be educated on our equipment so they know how to work around it when we show up with a patient that equipment has been utilized on. I'm telling ya, you don't do this every day, you don't understand the logistics and until there is rock solid, evidence based, peer reviewed documentation on it, it's simply not worth discussing. Buy your niche, edgy weird shit and keep it in your own pack or you like, but the rest of us are going to use evidence based medicine to keep ourselves, our families and our patients safe. 👍
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u/PerfectEqual3115 15d ago
I don't know what's going on with some people here on Reddit, but lots of people are of the opinion that North American Rescue is the ONE. The best of all. But as soon as a new, innovative brand comes along that has brought a really good product to market, it's immediately bullshit. Read the comments on the Snakestaff Tourniquet Gen. 2 and get your head straight. The Snakestaff Gen. 2 Tourniquet now has over 3,000 positive reviews. Get involved with new products, test them out, and then judge. Don't say in advance that it's bullshit even if you've NEVER dealt with the product or brand before.
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u/TovarichBravo EMS 15d ago
Everything is bullshit until it passes required tests and is proven on the market. This isn't a video game. This is real life and if you're dealing with a legitimate arterial bleed you have seconds. You need your product to work and work right now, every time.
Just fyi, I work on an ambulance and do this type of shit for a living. I've seen the dead and fucked up bodies of people who relied on bullshit tourniquets and equipment. If you're willing to gamble your life away, that's one thing, good riddance to ya, but don't peddle your bullshit for some other poor soul to die because of.
NAR is the standard because we all know it works. You want to reinvent the wheel to be edgy and different, and when it comes to staying alive or extanguination, I'm picking a tried and tested product that I know for fact works. No need for a fuckin attitude because I choose life over experimentation. 🖕
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u/struppig_taucher 15d ago
Evidence Based Medicine is not about reviews but about evidence, evidence like studies, clinical overviews and so on. NAR is not 'the one'. This is a saying due to NAR being a really popular (and based) company selling great medical equipment. Tourniquets like the Rhino Rescue, Norse Rescue, Snakestaff, Amazon, Temu, etc companies do not work because they are poorely built and not recommended by the Comittee of Tactical Combat Casualty Care (CoTCCC), Comittee of Tactical Emergency Casualty Care (CoTECC), and TREMA Europe FOR A REASON They have to go through long studies, certifications, get recommended, and so on. This cannot happen from today to tomorrow, but rather takes a minimum of a few years.
As another guy iirq already said, you don't want to gamble with life-or-death scenarious. Just fucking use the proven equipment and move on.
As I have seen that you speak German better than English, you can DM me in German so we can continue this in German because I also speak your language.
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u/VXMerlinXV RN 14d ago
As others have said, comments and reviews aren’t how medical devices are vetted. I have no problem with the ETQ wide moving forward into clinical testing. But they’re already for sale, which either means Snake-boys don’t understand how to bring a medical device to market, or they do, and are choosing to ignore that process. Neither of those are good options.
It also readily explains why the American College of Surgeons and CoTCCC haven’t touched it yet, there’s no relevant data for them to base an opinion on.
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u/Condhor TEMS | Instructor | CCP 15d ago edited 15d ago
Recommended, not approved, CoTCCC TQ’s:
TMS SOFTT-W, m2 RMT, CAT GEN 6/7, CMS TMT, SAM-XT, RevMedx TX2/TX3
(Pneumatics: EMT for $360, and TPT2)
Not included: RAT, SnakeStaff ETQ's, SWATT.
https://books.allogy.com/web/tenant/8/books/f94aad5b-78f3-42be-b3de-8e8d63343866/