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BST First Aid – Apply a Tourniquet

Apply a tourniquet

Training Support Package (TSP) for the Marine Battle Skills Test (BST)

 

TASK: Apply a tourniquet for the Battle Skills Test

CONDITION: Given a casualty, Individual First Aid Kit (IFAK), and Combat Application Tourniquet (CAT)

STANDARD: To prevent further bleeding or death

ESTIMATED TIME TO TRAIN: 15 minutes

ESTIMATED TIME TO TEST: 5 minutes per Marine

PERFORMANCE STEPS: 

  1. Evaluate the casualty for life threatening bleeding
  2. Select the appropriate material for a tourniquet
  3. Identify the proper location for the tourniquet
  4. Place the tourniquet
  5. Assess the effectiveness of the tourniquet
  6. Mark the casualty with the time and date the tourniquet was placed

REFERENCES: 

  1. Pre-Hospital Trauma Life Support, Military Version, Current Edition

SUPPORT REQUIREMENTS:  

  1. IFAK or Training IFAK
  2. A simulated casualty with a wounded extremity (role-player or mannequin)

PERFORMANCE STEP 1: Evaluate the casualty for life threatening bleeding.

Evaluate the casualty by determining the location, type, and size, and severity of the wound.  Always look for more than one wound to include an exit wound.  If required cut or tear clothing and carefully expose the entire area of the wound. The types of life threatening bleeding are:

Venous Bleeding (Significant/life-threatening): Veins are blood vessels that carry blood to the heart.

Characteristics: Steady flow of dark red-colored blood.  Controlled with direct pressure and requires immediate attention.

Arterial Bleeding (life-threatening): Arteries are blood vessels that carry oxygen rich blood from the heart.

Characteristics: The most dangerous type of bleeding.  Blood is bright red colored and spurts with each heartbeat.  Arterial bleeding requires immediate attention. 

PERFORMANCE STEP 2: Remove CAT from tourniquet pouch.

Combat Application Tourniquet (CAT): The CAT is used to stop arterial and venous blood flow from the arms and legs and can be rapidly applied. 

PERFORMANCE STEP 3: Identify location for tourniquet.

Determine which limb the tourniquet will be placed on. The tourniquet should be placed between the wound and the heart, 2 to 4 inches above the injury.

 

PERFORMANCE STEP 4: Place the tourniquet.

  1. Insert the wounded extremity through the loop of the self-adhering band placing the tourniquet between the wound and the heart, 2 to 4 inches above the injury. If the wound is close to a joint (knee or elbow), place the tourniquet directly above the joint.
  1. Pull the self-adhering band tight and securely fasten it back on itself.
  1. Wrap and adhere the band around the extremity. Do not secure the band past the clip.
  1. Twist the windlass rod until bleeding has stopped.
  1. Lock the windlass rod in place with the windlass clip.
  1. Secure the band over the windlass rod. For small extremities, continue wrapping the band around the extremity and over the windlass rod.
  1. Secure the windlass rod and band with the strap. Grasp the windlass strap, pull it tight, and adhere it to the opposite hook on the windlass clip.

PERFORMANCE STEP 5: Assess effectiveness of tourniquet.

Occasionally check to ensure blood flow has stopped and evacuate casualty as soon as possible.

PERFORMANCE STEP 6: Mark the casualty with the letter “T” and place the time and date on the casualty’s forehead.

Mark the casualty’s forehead with a “T” and write the time and date below or alongside the “T” to indicate when the tourniquet was applied.  If necessary, use the casualty’s blood to make this mark.

 

 

Evaluation Checklist

 

MARINE BEING EVALUATED:

EVALUATOR:

DATE:

SUPPORT REQUIREMENTS:

  1. IFAK or Training IFAK
  2. A simulated casualty with a wounded extremity (role-player or mannequin)

EVALUATOR NOTE: Marines must perform all the steps below without error in order to pass this event.  Evaluators will guide the Marine being evaluated through the steps listed below by asking questions.

Performance Step Instructor Notes Pass or Remediate
1. Evaluate the casualty for life threatening bleeding 1. Simulate checking the casualty for two types of life threating bleeding (venous and arterial)

2.  Ensure the casualty is checked for multiple wounds

2. Select the appropriate material for a tourniquet 1. Remove the CAT from pouch
3. Identify the proper location for tourniquet. 1. Determine the correct limb and place the CAT 2 to 4 inches above the wound
4. Place the tourniquet 1. Insert the wounded extremity through loop of self-adhering band placing the CAT between wound and heart 2 to 4 inches above the injury

2. Pull the self-adhering band time and fasten it back on itself

3. Wrap and adhere the band around the extremity

4. Twist the rod until bleeding has stopped

5. Lock the rod and in place with windlass clip

6. Secure the band over the rod

7. Secure the rod and band with the strap

5. Assess effectiveness of tourniquet

 

1. Occasionally check the wound to ensure the blood flow has stopped
6. Mark the casualty with the letter “T” on the forehead along with the time and date. 1.  Simulate marking the casualty’s forehead with the letter “T”.

2. Write the time and date below or alongside the “T” indicating when the tourniquet was applied.

 

 

Apply a tourniquet  Training Support Package (TSP) for the Marine Battle Skills Test (BST)