Adult Tourniquets for Kids’ Trauma

Photo from North American Rescue

A recent article published in the June issue of the journal Pediatrics, indicates that Adult Combat Application Tourniquets (CAT) are effective for use in school-age children.

I don’t follow the pediatric trauma literature because I’m in general office care, so this was news to me. It seems that previous studies of children and tourniquets have involved rescue mannequins and studies of average limb circumference for age group. What makes this study unique is that it is a prospective study which involved actual children ages 6-16 with actual CAT use and Doppler measurement of arterial flow.

This is good news for those with Stop the Bleed training. Solid evidence that an adult Tourniquet CAN be used effectively in a pediatric trauma situation is likely to be reassuring.

What isn’t surprising however, is the focus on “Gunshot injuries” in the article as well as in the hand-wringing commentary which follows it on the next page in the journal.

The commentator laments the,

“… appalling social conditions that make an article on how to stop 6-year olds from bleeding to death after gunshot wounds necessary in the first place.”

He goes on to scold that,

“Almost as tragic is the inurement to school shootings and resultant ease with which we, the putative guardians of children’s health, can blithely read such articles with scarcely a second thought about the existence of the larger problem: repeated mass injuries from school shootings. The United States is the clear world leader in both absolute and relative frequency of school shootings, with >250 reported since 2009.”

First of all, I can’t take this commentator who is supposed to be a physician seriously at ALL. You know why? Because he uses freaking WIKIPEDIA as one of his references for his school shooting data.

Seriously? Dude, do you even know how to do academics? You make my head hurt. How did this get published in a major journal? Oh I know – because you spouted the party line, that’s why.

This obsessive and myopic (not to mention sloppily supported) focus on “gunshot injuries” and “school shootings” obscures the value of this study and the wider benefit to pediatric trauma victims in general. What about the thousands of children who experience traumatic injury in motor vehicle accidents yearly? This is a number which far exceeds pediatric gunshot injury, yet the commentator chose the latter rather than the former as the focus of his emotional finger-waggling.

The commentator’s hypothetical 6-year old is much more likely to need a tourniquet after her mother wrecks their car than because of a school shooting. But that apparently didn’t occur to the commentator nor to the authors of the study, who used “Gunshot injuries” as their first attention-grabbing words.

This tunnel-vision is typical of the American Academy of Pediatrics and Organized Medicine in general though. I don’t know why I expected anything different. Never let facts stand in the way of the narrative, and always be sure to muddy-up otherwise good research with an emotional and political smokescreen.