Policies and Training

Is It Time to Train Security Officers and Employees to Use Tourniquets?

One of the important survival lessons learned from the U.S. involvement in the war on terror in Iraq and Afghanistan is that the use of tourniquets certainly saved the lives of many combat personnel. While these devices are very common in hospitals and on board ambulances, their use is starting to spread, as law enforcement officers are being trained to carry and use them, to treat their own wounds, or for their partners, or as first-arrivers on serious-injury medical calls.

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The use of tourniquets in a workplace setting would most likely be called on for serious employee injuries from vehicle or equipment accidents, which are much more likely than bullet, knife, or bomb wounds caused by an active shooter or mass attacker. Still, the possibility, however rare, of those events, may be what convinces a company’s senior management or the contract security officer provider firm to invest in a supply of tourniquets (which can range from $10 to $25 each, depending on the model and degree of medical sophistication) and the necessary first-aid training to use them effectively.

Like automated external defibrillator (AED) devices, where it makes sense to train all on-site security officers first, then all volunteering employees who want to know how to use them, tourniquet training could be just as valuable, timely, and significant. Security officers could carry tourniquets with them as well as have them in all first-aid kits (including those stored in security patrol vehicles).

Most Combat Application Tourniquets (CATs) feature a similar design: a main loop, which slips around the victim’s extremity at a point about 2 to 4 inches above the wound; Velcro® straps to hold the loop in place; and then the use of a so-called “windlass rod” to twist (usually no more than three times) to make the tourniquet tight around the extremity above the wound. (The name “tourniquet” comes from the French verb “tourner” or “to turn.”) Actual tourniquets that are designed for that purpose are far superior to using something like a belt, which is not medically sanitary and lacks the rod to make it tight enough to be effective.

Using a tourniquet on a victim who is bleeding severely is not a simple decision, especially without formal first-aid training. Tourniquets left on for 2 hours or longer without medical supervision can cause tissue loss and nerve and muscle damage, all of which may require an amputation. But if direct pressure to the wound is not possible or working, the tourniquet may be the only way to save the victim’s life until the arrival of paramedics or the intervention of a hospital trauma team.

Training programs that cover the use of tourniquets for security officers or key employees at a site can help those users feel more comfortable about using the device in a highly stressful and life-threatening situation. A hospital in Denver is now offering training for interested citizens in the use of bandages and tourniquets. The class lasts just over 1 hour and was created in response to the mass attacks in Orlando and Las Vegas. The function, of course, is not to turn people into paramedics, but to put those who want to know what to do when they come across someone with a gunshot wound, a car accident injury, or a similar avulsion (where a person’s limb has been severely injured or torn away), and make it possible for them to use tourniquets effectively,

The local Red Cross chapter may be able to provide tourniquet training as part of a first-aid class for new security officers or interested employees, or as a refresher for those who have had some training before. Former military combat medics have created first-aid training programs for their clients, based on their field experiences and knowing that when used properly and quickly, that tourniquets save lives.