I'd like to make sure I understand your post regarding the tourniquet. As I've understood from the article, he believed he had a choice between applying a tourniquet, which guarantees the loss of the limb, and not applying the tourniquet but potentially bleeding to death.
Perhaps it all depends on how bad the bleeding was but it seems as though he made the correct decision? Am I at least understanding correctly that the decision saved his leg?
It seems as though the Leroy Petry story is significantly different in that the limb (or the hand) was already lost. In other words, Petry was not faced with the same decision and it was obvious that he needed to apply the tourniquet.
I'm very interested in your thoughts and want to make sure I understand why you said "he exposed himself to the risk of bleeding to death...for no benefit".
Harvey and I think alike, as we often do.
The problem with bleeding is that it is a one way street, in a wilderness setting. You cannot really replace the oxygen carrying capacity in any way. Even I or a paramedic (sans blood transfusions) cannot really do much about blood loss. You get into things like Trendelenburg positions, but the effect only buys a little time.
So stopping
significant bleeding is one of the most important first aid priorities.
For a long time, the "conventional wisdom" has taught in first aid that application of a tourniquet "guarantees" the loss of a limb. I think this was implied so that people would not abandon direct pressure, which works an astonishing amount of time, if done right. In fact, it does no such thing. Tourniquets have to be used correctly, though. I vaguely remember the way they were taught was to apply them, AND NEVER RELEASE THEM.
In the case being discussed, that would have been SIX DAYS.
NOT GOOD.
As Harvey stated, "Bleeding always stops"--one of the rules of surgery (and an inside joke). GENERALLY, bleeding does, as arteries constrict, as blood clots form, etc. If you can slow the deluge down while that happens---and also apply direct pressure where possible---it will almost always stop. Once it has stopped, no more need for the tourniquet.
Note that that process actually happened in this hiker (except that he lost quite a bit of blood (?) until it stopped.)
