He likely felt little when the round struck him due to a previous wound in which he was said to have
sustained nerve damage to the same leg. It was said that he was leading a charge on an entrenched enemy position and may have been as far as 40 yards ahead of his soldiers he commanded. He was hit behind his knee causing arterial bleeding from his popliteal artery. As he began going into shock, with an apparent altered mental status, his top aide asked him if he were wounded. He replied with his last words, “Yes. And I fear seriously.” He lost consciousness as his staff carried him to cover in a ravine to assess him. This is when a small wound behind his knee was noticed, his boot full of blood. Some say that his fellow officers tried in vain to improvise a tourniquet not knowing that he had one in his pocket. Others say that they found the commercially made tourniquet in one of his pockets but didn’t know how to use it. Either way it was too late. The General’s heart had ceased to beat due to blood loss.
Gen. Albert Sidney Johnston died as the battle Shiloh raged around him at 2 p.m. on April 6 1862.
This happened over 150 years ago.
While I am usually not a fan of sensational pieces such as this, I feel that this story is worth sharing in this way because similar preventable deaths still happen to this day, over 150 years later. This, despite the wide availability of approved commercially made tourniquets as well as advances in research and knowledge on the topic since the first recorded tourniquet use described in 1674. It is now 2016 and scientifically-studdied, combat-proven tourniquets are available to anyone with 30 bucks and a sense of responsibility. You don’t have to be a general or a surgeon anymore but if you want to read more about General Johnston’s death and life in an entertaining and educational way, I highly recommend Jeff Sharra’s novel based on the battle of Shiloh, “A Blaze of Glory.”
There are clear recommendations on tourniquet use backed up by research and lessons learned and re-learned the hard way in recent theaters of war and by civilian and federal medical organizations here in the US. The Committee of Tactical Combat Casualty Care, The Hartford Consensus and even the White House all advocate stopping extremity bleeding due to trauma as soon as possible to prevent loss of life. Modern commercial tourniquets save lives almost daily in communities all over the United States applied by civilians, veterans, law enforcement officers, and first responders of all training levels.
Improvised tourniquets almost universally fail when they are most needed. All 27 of the tourniquets made on the spot during the aftermath of of the Boston Bombing failed at completely stopping extremity bleeding. In a scientific study by Army researchers improvised tourniquets failed to stop extremity bleeding 70 percent of the time. That means the crap seen in movies about making a tourniquet from a strip of cloth or worse, a belt, will result in unnecessary loss of life without additional, continuous pressure. This limits you to effectively treating only one or two people at a time while you hold manual pressure instead of applying an effective tourniquet to one patient before confidently moving on to the next or addressing the overall situation.
Get an approved tourniquet such as the Combat Application Tourniquet(CAT) or the Special Operations Forces Tactical Tourniquet-Wide( SOFTT-W) from a reputable seller (counterfeits exist and are dangerous!) and learn how to use it. Training is crucial. We advocate carrying them in an extra pocket, backpack, purse, in your car, anywhere within reach. If not, it won’t do any good and precious red blood cells will be lost unnecessarily lowering the chances for survival. Tourniquets are completely legal for carrying onto a plane or other events where security does not allow weapons. It’s about you taking responsibility for you and your loved ones.
Mass Casualty trauma kits should be available anywhere there are large numbers of people congregating. If you attend large events ask if the organizers have adequate security and adequate trauma supplies in case something terrible were to happen. If you don’t care and take the time to voice it, they won’t care either. There is no mandate for a minimum number of tourniquets at such an event.
First responders would do well to remember that one of the easiest ways to decrease preventable loss of life when responding to a mass casualty event is to have adequate supplies of tourniquets and wound packing material available upon entry. Maybe in a duffle bag or large backpack which would be dropped at the scene with other responders aware of it and it’s contents.
“But won’t you get gangrene and lose your arm or leg because of the tourniquet?”
Tourniquets are used safely hundreds of times per day for hours at a time in operating rooms all over the world during major surgeries. Our soldiers have been using the same combat tourniquets we advocate using with an incredible safety margin. Read this article from the Trauma Monkeys blog for more tourniquet myths debunked.
If you want to do some of your own research, there is a link to my Google Drive Tourniquet folder below. I have no financial disclosures, this is all done with private money and personal time.
Get a Tourniquet and Get Trained.