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'Game changer:' Tourniquet for abdominal wounds is already saving lives (stripes.com)
112 points by shill on Sept 2, 2013 | hide | past | web | favorite | 24 comments

Great product, I'm sure. CAT's should be mentioned too, they're used on arms and legs and can be applied quickly. Hope I'll never have to need one (not serving)

'preventable death'... Policy and politics has the ability to prevent death by greater numbers even before we feel the need to rupture the aortas of our fellow human beings.

I'm curious, I was told most use cases of tourniques would require subsequent amputation. Is this the case here, as well? Do you amputate the pelvis? What would the life of a soldier look like in the hours, days after he received an injury to the abdomen and being saved by a device like this?

For most practical purposes, use of a tourniquet implies a choice between death of patient and loss of limb.

Part of the emphasis on this choice in first-aid classes is to keep people from over-using tourniquets for injuries which do not pose a risk of loss of life.

A laceration to the hand can look awful, but some pressure and elevation can minimize blood loss even if definitive care is hours away without risking loss of the hand or forearm by using a tourniquet.

In a massive trauma situation, such as from multiple penetrating wounds, if the patient bleeds out and dies, other tissue damage does not matter much.

If the patient survives injuries that make it a good idea to block the abdominal aorta - https://en.wikipedia.org/wiki/Abdominal_aorta then there is a good chance he/she has survived due to good and rapid field treatment, and rapid evacuation to a definitive care facility that can manage any other tissue damage caused by lack of circulation below the diaphragm.

> I'm curious, I was told most use cases of tourniques would require subsequent amputation.

This is very vague. I was trained to tie tourniquets for the limbs (arms and legs). I was taught that it takes a few hours before cell death sets in and about four until complete loss of limbs. This means that if you can get the wounded to a hospital (or a well equipped surgeon) quickly enough, you can even save the limb.

For other places like the abdomen and torso, the story is different.

It is undeniable, but of real regret, that many major medical advances are made during wars. Even so, this is fantastic.

Lots of raw material. Pun intended.

Also, several occasions where it's impossible to apply the tried and true, so some medic has to hack a new solution to an old problem from what's available on site, and, one time out of n, it actually works. Not that this is the case.

Wars mean lots of money is spend on stitching up people (and blowing them up in the first place).

Without wars, we could save the resources used for the blowing up part.

Yes, but we'd spend the savings on curing erectile dysfunction.

Beats being blown to pieces.

Also, please don't pretend erectile dysfunction is not a real problem to the people affected.

Of course it is, but a far greater proportion of medical effort goes into fixing problems like ED than would be prescribed according to the utility of fixing them. The reason these things get the focus they do is because they're profitable.

And that's the point: war makes research into treating basic trauma profitable in a way that everyday life doesn't. It's not worth it, but those are still the apparent facts. I mean, look at how low hanging the fruit described in the article is. If that were a device for making a man's penis hard, it would have been invented 15 years ago.

Sildenafil was invented for angina, for which it was ineffective. However, it was noted to cause erections (as a side-effect). This side effect was then approved as the primary indication for the medication.

So the historical research into the drug was actually for the purpose of curing "serious" diseases, although I agree with eru that ED is a meaningful problem for those who are affected by it, and there is some serious utility gained from fixing the problem.

That's true, although while noticing the effect from a drug gets a good chunk of the way there, there's still a huge amount of effort after that which goes into getting it approved and to market. And vardenafil seems to have been researched purely with ED in mind.

That said, ED isn't really a perfect poster child for the kind of medical research I'm talking about. It's just the best one to use with a one-liner because it conveys the point effectively, and because penises are funny. Other examples include treatments for male pattern baldness and second/third generation antihistamines.

With the former, the pharmacological options are all again opportunistic situations, although the point about investing in getting them to market still applies. With the latter, that is not the case. And although there's no denying that they have vastly improved the quality of life for people with serious allergy problems, there's also no denying that the main reason for the investment put into them was helping people with the spring sniffles (as evidenced by the fact that their approved doses are set so low that they are barely of any use to anyone (otherwise they wouldn't have passed muster for "non-drowsy" so that they could get fast track approval from the FDA)).

I think the snarky remark that you're looking for is baldness. The erectile dysfunction discovery was an accidental discovery for a different problem.

I don't suppose you have any numbers for the amount of money spent on various medical research?

If this works as reported, this is truly great. But you know what would save even more lives? If we got the f&ck out of Afghanistan. What are we even doing there? When is this last time a reporter asked the President about the Afghan war and when it will end? The tolerance of the current situation just baffles me.

I don't know if the sunk cost fallacy applies to politics and war but I suspect that comes into play here.

Recent (July) articles indicate he's considering a withdrawal in 2014.

This article is interesting as well http://www.realclearpolitics.com/articles/2013/08/08/obama_s...

And just this morning in the news I heard about bigger plans for Syria than just a few air strikes.

We got out of Iraq and plenty of lives are still being lost there, even though the government is still in place. Afghanistan is a tougher case. They will lose even more lives.

The Iraqi government actually wants US troops to return...

More than a bit ironic in a lot of ways.

Huge!! It's crazy how something so deceivingly simple took so long to invent.

Black Hawk Down has a scene where the difficulty of containing such injuries is illustrated very graphically: http://www.youtube.com/watch?v=gixRgsPFR7g

It's incredibly difficult to stop such bleeding and having such device will undoubtedly save lives on and off battle fields. For example in bad car wrecks.

Unfortunately what works in war doesn't necessarily work in peace. We though a couple decades ago that anti-shock garments (basically inflatable pants) save lives after trauma by redirecting blood to the core, but in reality it's likely that the practice causes harm, and you just never see them used anymore at all. (http://summaries.cochrane.org/CD001856/no-evidence-that-medi...)

As amazing as this is I can't help feeling a tinge of horror that it's even required.

it doesn't have to be a gunshot wound. it could just as easily save lives of people in car accidents.

Might be useful in some surgeries as well; like total hips.

This could save many people back in the country as well, it would turn out to be impressively useful for car accidents or similar events, every ambulance should be required to carry it imho

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