LIFESTYLE

Counterfeit Tourniquet Dangers // Would You Trust Your Life to a Dupe? // Surprising Dangers of Fakes

On May 9, 2019
By Kimberly

It’s the first National Stop the Bleed Month, it’s “Tourniquet Thursday,” it’s Teacher Appreciation Week, and I’ve spent the last six months advocating for supplies for teachers in our school and accumulating Stop the Bleed training as well as bleeding control equipment for my classroom.

In an effort to learn as much as possible about bleeding control, I’ve spent hundreds of hours researching. I’ve read and written about everything from chest seals to tourniquets, from how to use your classroom supply money to purchase bleeding control kits, to what to put in your bleeding control kit.

Tackling the Topic of Counterfeits

Since January, I’ve been working my way through a Tactical Casualty Care Class from Dr. Shertz with Crisis Medicine. I knew from his training that fake tourniquets are on the market. Also, I also learned they are untested and have a high potential for failure.

Concerned, I researched what dupes would look like, why they were made, what would happen if someone accidentally used one. Then, I started researching the legal problems with them in an effort to become more educated on the subject.

My findings are that there are medical reasons counterfeit tourniquets are extremely dangerous, and there are legal liabilities for using them. This article will cover the dangers in their use, and a second article will cover the legal aspects.

How Someone Could Accidentally Purchase Fake Tourniquets

Without in-depth training, reading, and researching, someone might not even realize that there is such a thing as a counterfeit tourniquet, or how dangerous it is to rely on them.

So, with that in mind, I continued to research how counterfeit tourniquets even get into the hands of citizens, law enforcement, and even the military.

Recently in my sailing class, I worked with some Rangers from Ft. Benning, Georgia, who told me they had received counterfeit tourniquets which were immediately recalled upon realization.

The fact is, the fakes are being sold. They have infiltrated online shopping venues, and are such close dupes to the real thing that the differences in dimensions are measured in millimeters.

There are sellers who take on the names of prominent authentic suppliers, just like they do in everything from handbags and sunglasses to wine and cigars. Then they duplicate the logos, instructions, and paperwork.

Companies manufacture counterfeit tourniquets for Airsoft players who want to dress in full costume, I learned. These fakes have infiltrated the market and are difficult to distinguish.

Why Would Someone Choose Fake

To save money. Or to be able to afford more. Quality is not cheap.

Real tourniquets are not inexpensive. People might be tempted to have three less-expensive tourniquets in a misguided attempt to stock more rather than one real tourniquet at a higher price point, without knowing how dangerous they actually are.

In stocking my own bleeding control kits, I became familiar with prices of tourniquets with the approval of the Co-TCCC, Committee on Tactical Combat Casualty Care.

Quality is not inexpensive, and tourniquets recommended by the Co-TCCC are at least $24. That is one way to distinguish a counterfeit from the real thing; price. Counterfeits are often offered as low as a third of that price.

School districts can qualify for discounts, for instance, Georgia’s School Response Program took advantage of special pricing and purchased over 29,000 bleeding control kits for under $40 from North American Rescue through their Community Preparedness.

Those Community Preparedness products are offered by North American Rescue for 25% off during the first National Stop the Bleed Month, May of 2019, making CAT tourniquets even more affordable, not that cost should be a factor in potentially saving lives.

Identifying Fakes

The New York State Volunteer Ambulance & Rescue Association, Inc. produced a detailed Photographic & Measurement Comparison that is a real eye-opener to how far counterfeit tourniquet manufacturers have been able to duplicate the real thing.

One of the resources I listed below recommends ordering one tourniquet if you are unsure before ordering multiples. Or, better yet, go straight to the manufacturers and purchase directly from them.

There is such a big market for counterfeits that North American Rescue, a company that distributes CAT tourniquets, issued a video covering some of the characteristics to look for when identifying counterfeit tourniquets.

Trusted Then Failure

Someone erroneously might believe it’s not a big deal to have a fake tourniquet, or that the quality will be just slightly inferior. It’s much, much worse than that according to the trained professionals.

I’m not the expert, however, I have learned that these are tourniquets that could very likely fail, or put you in even more danger.

A person can bleed out from a wound in three to four minutes; in less time than emergency professionals can be on hand to assist. That means all tourniquets need to be dependable, tested, and reliable.

In a mass casualty event, a caregiver might treat several victims. Moving quickly from one to the next, they could leave one casualty, thinking they are stabilized, and move to the next without realizing the tourniquet failure.

Many articles and videos on why counterfeit tourniquets are a problem are readily available. While counterfeits may closely resemble legitimate commercial versions, they truly are not held to the same quality standards. This Bonus Content from Crisis Medicine has a video about the dangers of counterfeit tourniquets.

Emotional Ramifications

“As a firefighter/paramedic that treated a lot of critically injured children, even if from an accident in the school and not an active shooter… This can be a traumatic event and a failing piece of what should be lifesaving equipment will devastate the rescuer (a teacher in your case) and if that has a bad outcome it will be even more devastating and an unnecessary loss of life,” Chris Hoyne, Director, Community Preparedness Programs, North American Rescue, LLC

He presents a valid point about the emotional results of faulty equipment for caregivers in already upsetting situations.

The disappointment, grief, and second-guessing would be distressing and life-altering, possibly for all involved.

Regulations and Recommendations

Medical devices are regulated by the Federal Drug Administration. Counterfeits are such a concern, that medical facilities must self-report device malfunctions. In some cases, it is appropriate to report suspected criminal activity related to FDA-regulated medical device, which tourniquets are. I’ll publish a second article covering these ramifications soon.

There are lists of recommendations produced regularly by the
U.S. Department of Defense Committee on Tactical Combat Casualty Care, or Co-TCCC. This list was updated on Monday, May 6, 2019. Here is the new Co-TCCC listing of tourniquet recommendations.

Another influential group is The Special Operations Medical Association, known as SOMA. Their goal is education and professional development of special operations medical providers. In other words, the biggest names in pre-hospital care in military and civilian providers from around the world gather regularly.

One of my sources is Mike Shertz from Crisis Medicine. His background is as an Emergency Physician, and he’s a founding member of the Guidelines Committee for the Committee on Tactical Emergency Casualty Care.

He is certified in Emergency Medical Services, and was a US Army Special Forces Medic, and is an expert in his field. His training made me aware that counterfeits exist, and to be aware of them.

I’m just a teacher who is still learning. Definitely, I am not the subject matter expert. Daily, I am still learning, and the minute I stop learning or stop seeking further knowledge, I also will fail as a teacher.

More Dangerous Than Improvised Tourniquets

Faulty tourniquets can become venous constricting bands – they accidentally can increase bleeding instead of stopping it.

This makes counterfeit tourniquets even more dangerous than improvised tourniquets.

Covered in depth in the Crisis Medicine Tactical Casualty Care Course by Dr. Mike Shertz; this link will give you diagrams and information.

Anything from inferior stitching, to an easily breakable windlass, to faulty assembly could malfunction in an emergency.

The CBS Evening News in August of 2015 published a news release and article, “Beware: Counterfeit tourniquets could cost lives” that covered some catastrophic failures of fakes. Real-life accounts presented in it are so upsetting. I had trouble reading it, it was so awful.

Role of Teachers in Bleeding Control

These days, teachers have responsibilities far beyond just teaching. We do everything from retrieve breakfasts from the cafeteria and serve them in our classrooms, to escorting students to the bathroom. Some of our work is pretty far from actual teaching activities.

Part of my professional code of conduct reads: “Shall make reasonable effort to protect the student from conditions harmful to learning
and/or to the student’s mental and/or physical health and/or safety.”

We are teachers, and our contracts include statements such as “perform duties assigned as needed,” and bleeding control training is now one of my duties. And if I’m going to do something, I’m going to do it well.

My principal has said it’s part of my job; and so it is. It’s sad that our duties include professional learning about these topics, but that’s the reality.

Why To Stage Your Tourniquet

From my Crisis Medicine training and from other reading, I know that bullet wounds are not sterile. That means there is no reason to not open your tourniquet, remove the outer wrapping, and stage it.

Through training, I have learned that seconds count.

Our Stop the Bleed trainer told us we have thirty seconds to get that tourniquet on and start tightening. Scary, but I could spend those thirty seconds searching for something to break into the kit, unwrapping the tourniquet, and trying to remember how to assemble it.

So, I open my kits and stage my tourniquets. Seconds count.

Weekly, every Monday, I open my own personal kit and re-familiarize myself with the contents. EVERY Monday, here’s the link to my check on Monday of last week. Sometimes my students even watch me. It reassures them that I am prepared and have a plan. Medical professionals perform this check daily. I’m a teacher first, but these days, this is now a responsibility of ours as well; it’s part of my job.

Why Schools Are Buying Bleeding Control Kits for Classrooms

As a part of school hardening, our county has been implementing various physical modifications to our campuses for over a year. Classroom doors are now locked during class, entryways have been limited to a few, and other safety measures have been implemented as needed at schools.

The “Stop the Bleed” national awareness campaign promoted in October 2015 encourages every American citizen to learn hemorrhage control with bandages and tourniquets so the population is trained to help save lives.

So, part of this effort to increase school safety includes Bleeding Control training. Every school in our county, mine included, had a thirty minute faculty meeting to introduce bleeding control training and supplies.

Classroom kits are preferable to one large kit in a central location because in the event of an active shooter, schools go on lockdown. In lockdown, everyone is locked in their own room and not able to go retrieve supplies.

Therefore, having a bleeding control kit right in the classroom improves the chance of surviving any type of catastrophic bleeding emergency.

Also, if an active shooter was present, emergency medical technicians will not be able to enter the building until law enforcement “clears” the campus for EMT’s to enter. That will take at least 10 minutes, which is too long.

Our School’s Stop the Bleed Training

Our instructor was from the Florida Department of Health in our county. He covered wound packing using a model and demonstrating what volume of material and what pressure would be necessary.

Use of tourniquets in bleeding control was covered. Using a model of a leg, he demonstrated where to place a tourniquet, how tight to make it, and other information. Also, he briefly discussed improvised tourniquets.

The training was quick, but relatively thorough for such a short demonstration. I took notes, sat in the front, and told him I was writing an article about our bleeding control training. He encouraged us to spread the idea to other teachers that we need training and supplies.

Then he told us we would receive a kit with gloves, bandages, gauze, and a tourniquet. Our kits arrived this week! The exterior graphics are from BleedingControl.org, the Save a Life Flowchart.

Spreading the Knowledge of the Need for Supplies and Training

In my classroom, I have one sealed North American Rescue Bleeding Control Kit with one CAT tourniquet, a North American Crisis Response Kit with four CAT tourniquets, and my own Classroom First Aid/Bleeding Control Kit with three more CAT tourniquets. Eight tourniquets in my room as of now.

As the debate about RATS tourniquets continues, up until a few days ago, I also had one in my bag. On campus, we have service animals, police canine dogs, and agricultural animals. I’ve read a lot about using the RATS on animals and very slim children.

When the Co-TCCC released the updated recommended tourniquet list Monday, and the RATS tourniquet was not on there, I removed it promptly. I need to do more research. Supplies and training – you can’t ever have enough.

My Efforts – Learning by Teaching and Listening

I’ve been producing articles weekly, and even articles daily during the week of the 20th anniversary of the Columbine shooting. I’ve emailed my co-workers with suggestions on items to order, and how to order them. I’ve courtesy copied my principal, members of our guardian program who carry on campus, and even our district safety officer. I want everyone prepared.

Over the last couple months, I’ve even discussed active shooter concerns with the security officer for the School for The Deaf and The Blind in St. Augustine several times. She is responsible for their entire campus plus all buses including those that make the nine-hour drive from Northeast Florida all the way down to Homestead, Florida weekly.

All are under her care and responsibility. She says her students are the softest targets imaginable. Since her students cannot hear someone knocking, she’s even having trouble getting her teachers to understand why it is so important to lock their doors.

Often, when I write, I think of her teachers, and her charges with their special concerns, and I hope to raise awareness in others.

How To Prepare

Schools all over the country are in the same situation – needing supplies and training. A worry is that trying to save money, schools may accidentally purchase tourniquets that may or may not be approved, be reliable, or be life-savers.

One thing I think we must all do is communicate with other teachers; you need training, you need quality supplies. We need to keep communicating where you can get both of those. We have to educate the educators so they will be able to recognize superior training, quality supplies, and make good choices.

Involving School Resource Officers

As part of my seeking knowledge, I’ve made a point of inviting every SRO or visiting deputy to my classroom to show them my kit, get ideas, confirmation, and, to familiarize them with the contents and location.

Not only do I want them all to know where my kit is and what it looks like, but also what’s in it. They know either I or an athlete in my class will throw it directly at them or the nearest wall to them so they have it in case of a crowd during an event.

My Monday Morning Routine

The first day of school this year, I brought my kit and started my Monday Morning Routine. EVERY Monday, I open it, re-familiarize myself with the contents and check my headlamp battery.

Familiarity with my kit has been important – not only for me to know where each and every item is located in my kit, but also the ability to direct someone else verbally through my kit, and maybe in the dark, and maybe with sprinklers deployed.

Just like reviewing underwater hand signals before a dive, my Monday morning procedure brings my mind to fully concentrate on school. With so much information thrown at us daily, a bit of refocus is often necessary. It’s only been recently that teachers have had to increasingly concentrate on topics further from their course subject matter, such as bleeding control and arming doors and run-fight-hide skills.

What I’m Doing to Prepare

Through writing articles about my preparedness journey, videoing blogs about my new gear and unboxings all adds to my preparation. There have been additions and deletions to my supplies, as well as tentative moves toward having my own opinions – impossible without a lot of learning!

The weirdest philosophy specific to my classroom needs is probably about exterior shears. I say “no,” because in a classroom they will get borrowed and not returned.

So far, I’ve written articles about what books I’m reading, what courses I’m taking, and what supplies I’m saving to buy.

There have been some wonderful discoveries as a result of all my work! I’ve produced how-to’s for spending government supply and classroom supply money on bleeding control kits. I’ve contacted and been in touch with reps with MyMedic, North American Rescue, Tactical Medical Solutions, and other companies that supply equipment as well as training.

Next month, I’m even scheduled to address an assembly of Rotarians about bleeding control kits. Not as medical supply equipment expert, and definitely not as an expert medical technician, but as a classroom teacher who now finds herself seeking supplies and training as part of her job. My presentation is supposed to cover selection of supplies for a bleeding control kit as well as training – applicable to any business just as much as a classroom teacher.

Please follow my journey – you can find me here on my blog, or posting daily on Facebook and Instagram, and in my weekly video on YouTube. You can visit my “shop” page to find discounts for a variety of outdoor activities.

If you have any comments or suggestions, please leave them below. I’d love to hear from you.

Or, Read This Next: Classroom Bleeding Control Kit // High School Teacher Packing in the Classroom

Loads of Links

I’m going to toss several important links below – I might clean them up later.

The links I referenced:

https://www.jems.com/ems-insider/articles/2015/12/10-tips-to-prevent-liability-from-equipment-failures.html – this link from JEMS Journal of Emergency Medical Services addresses liability

https://www.medpagetoday.com/productalert/devicesandvaccines/21680 – FDA warning about consumers of fake tourniquets

https://www.crisis-medicine.com/not-tourniquet-without-windlass/ – how an inferior tourniquet actually results in a venous constricting band which increases rather than decreases blood loss.

https://thecounterfeitreport.com/product/595/ – this one is from Composite Resources, who manufactures the CAT tourniquets.

https://www.rescue-essentials.com/rescue-essentials-blog/beware-fake-cat-tourniquets-on-amazon/ – Rescue Essentials addresses counterfeits

https://medium.com/homeland-security/a-fake-tourniquet-could-cost-your-life-e095821c61f0 – Homeland Security

https://www.nysvara.org/news/2013/july/130717.pdf – extremely detailed photographs comparing both counterfeit and real

http://privatebloggins.ca/?p=670 – a bit of the airsoft information, toys produced and recommendation to only use CoTCCC/CCCWG

Updated May 13, 2019.