The Analytical Department and our automated systems process thousands of observations. For operational security reasons, the vast majority of reports are distributed solely to the Defence Forces of Ukraine. Only isolated, carefully selected fragments, cleared of in-depth analytics and key findings, are made available to the public.
Tactical Medicine: Risk Assessment of Arbitrary Hemostatic Tourniquet Loosening by Wounded Personnel During Evacuation
A systemic violation of TCCC protocols has been observed, involving the arbitrary loosening of hemostatic tourniquets by wounded personnel. This practice leads to critical blood loss and hemodynamic instability, posing a direct threat to the lives of the personnel.
The Operational Challenge
According to the Doctrine of the Medical Forces of the Armed Forces of Ukraine and the TCCC standard, the safe application time for a tourniquet is up to two hours. However, in high-intensity combat environments with complex logistics, evacuation times frequently exceed this limit. Driven by severe pain and the fear of limb loss, personnel lacking appropriate medical qualifications resort to periodic loosening of tourniquets (approximately every 30 minutes), which contradicts approved casualty care algorithms.
Analytical Assessment
Operational data analysis indicates that the practice of periodic tourniquet loosening lacks medical justification and is fundamentally flawed. In accordance with the unified clinical protocol for emergency medical care, the decision to convert or loosen a tourniquet must be made exclusively by qualified medical personnel. The primary root causes of these violations are the shortage of professional medics at forward positions and an insufficient understanding among troops of the physiological consequences of premature pressure release versus the risks of prolonged application.
Conclusions and Recommendations
Training focus must shift from the fear of limb loss to the absolute priority of preserving life. It is recommended to intensify educational efforts regarding the rules of tourniquet intervention. A strategic solution involves expanding tourniquet conversion authorities to personnel holding the Combat Lifesaver (CLS) qualification, alongside corresponding adaptations to tactical medicine training programs to include in-depth anatomy and physiology modules.