Hunters, anglers, and people who recreate outdoors are exposed to situations that could result in a catastrophic injury. While this is very (very) rare, it behooves us to be prepared, with both the gear (including tourniquets) and knowledge, to handle an emergency in the field before help can get there.

Tip 1: Recognize the Need.
I’ve had a standard first-aid kit of some kind for decades, and thought I was fine. It could be as simple as the Band-Aids, antibiotic, gauze, and tape in a zip-top bag in my backpack, camera bag, and range bag—or more extensive like the kit I always have in my vehicle. I thought I was ready for an emergency. Well, I was ready for a minor emergency, like a blister, cut, or splinter. One day at the range I heard a siren and it occurred to me that if there was a catastrophic incident, my first-aid kit, and my skills, would be wholly inadequate to handle a life-threatening situation.

Tip 2: The Basics of First Aid.
Regardless if the injury is to you or someone else, you need to remain calm and think clearly. Being prepared and knowing what to do will help control the situation. The A-B-C paradigm is a common training aid: Airway, Breathing, Circulation. Death happens fast if someone cannot breathe, so learn the Heimlich maneuver (for choking), and get CPR-trained to know when and how to help someone with a cardiac event. CPR training has changed, so don’t assume you are up to date.

Tip 3: What About a Tourniquet?
Rapid blood loss can kill a person almost as quickly as an obstructed airway, and if you are around firearms, arrows, knives, axes, chainsaws, and other cutting devices, a bad accident can result in profuse bleeding. To the average person, seeing a lot of blood is an unsettling experience, but panic or overreaction is not good. If the blood is oozing or can be controlled with direct pressure, then don’t get over-aggressive before help arrives. Your kit should have a few compression trauma wound dressings—essentially a large, solid chunk of sterile gauze that can be used to stop the bleeding, using as much pressure as needed (including your body weight if necessary). If this does not work, or blood is squirting out of a severed artery, a tourniquet may be necessary.

Tip 4: The Advice Has Changed.
Many, many years ago in my Boy Scout first-aid training, we learned to improvise a tourniquet, and were then told that we should NEVER use one, as it can cause tissue damage. Even at that time, I thought that was bad advice, because if you need a tourniquet, it’s because the person will die if you don’t immediately stop the bleeding, and potential tissue damage is a minor point. Well, the world advanced past me while I wasn’t watching and now tourniquets are standard issue for many people who are likely to be first on-scene at bad situations, like police, combat military, and emergency medical responders.

Tip 5: Having it is Not Enough.
So, I equipped my kits with tourniquets and figured I was ready—I was wrong! The real key is knowing when and how to use it. In a seminar I recently attended, they handed out tourniquets and we applied them to ourselves, and it was a real eye-opener. The key is cutting off all the circulation in an arm or leg, and it’s not easy. It hurts, it’s awkward, and even when done indoors, with no screaming, blood, or adrenaline, it took too long. The second time went faster and smoother, and when we switched to a leg, I was getting the hang of it.

Tip 6: Be Ready.
Tourniquets are cheap and there are a variety of styles; but most importantly, real training is a must. None of this is actually difficult, and while I’ve never been in a life-or-death situation, with a little training and preparation, I think I’m more likely to be useful now than I was a year ago.