Nov 2023. Blues Vol 39 No. 11

SURVIVING THE
STREETS
AROUND THE COUNTRY
THE TWIST THAT SAVES LIVES
Not that long ago any police commander who was buying tourniquets for officers
and urging their use when appropriate, would have been thought reckless.
But now more officers are carrying these life-saving devices on duty.
54 The BLUES
On April 15, 2013, two terrorists
placed bombs on the street near
the finish line of the Boston Marathon.
The bombs, constructed in
pressure cookers and concealed
in backpacks, exploded at street
level sending a hail of ball bearings
and nails flying into spectators
crowded on the sidewalks
and participants in the annual
footrace.
That blast killed three people
and wounded more than 260.
Because of the placement of
the bombs, most of the wounds
inflicted on the victims were in
the lower extremities. Sixteen of
the surviving victims lost limbs
to the blast or to medical amputation
because of the severity of
their injuries.
Some emergency medical
personnel were on the scene to
provide support for the race, but
many of the first public safety
personnel to reach the bleeding
victims were law enforcement
officers. Those officers did not
have emergency medical kits, so
they did the best they could.
Former Boston Police Commissioner
Ed Davis told USA Today
that the response to the bombing
was the reason he decided to
buy tourniquets for all of his officers.
“Anybody could see there
was just this enormous need,”
Davis said. “People were ripping
their shirts, pulling off their
belts, and trying to find anything
to help stop the bleeding. [Buying
the tourniquets] wasn’t a hard
decision.”
CHANGING VIEWS
Not that long ago any police
commander who was buying
tourniquets for officers and
urging their use when appropriate
would have been thought
reckless. The medical wisdom
of the day was that the use of
tourniquets to stop bleeding was
dangerous and could result in
amputation of the victim’s limb
and even death.
Historians say ancient Macedonian
and Roman armies used
tourniquets to stanch blood flow.
But widespread use of the tourniquet
began in the 1700s, and
they were used by both sides
during the American Civil War.
They were also widely used
in World War I, which is likely
where they started to be labeled
as dangerous. In 1916 the Journal
of the Royal Army Medical Corps
called tourniquets the “invention
of the devil” because soldiers’
attempts to use improvised tourniquets
on the battlefields of the
Western Front often led to tissue
destruction, loss of limbs, and
increased mortality.
Disdain for tourniquets in
emergency medical response
prevailed into the 1990s. Boy
Scouts and Girl Scouts studying
first aid just a few decades ago
were firmly discouraged against
using tourniquets to stop blood
loss because they would result in
the person’s leg or arm being cut
off.
Medical attitudes toward
tourniquet use in first aid started
to change in the late 1990s and
early 2000s. That’s when published
studies of casualties in the
Vietnam War started to reveal
that as many as 2,500 wounded
American soldiers died of
bleeding from extremity wounds
and that a substantial number
of those deaths could have
been prevented if the blood loss
had been stopped in the field.
That research was backed up by
reports coming in from Afghanistan
and Iraq. The Mayo Clinic
reports that blood loss from
extremity wounds accounted for
7.8% of the preventable deaths in
the early days of the Global War
on Terror. As the wars against al