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Equipment

A bamboo table with four different cravats laid out on it

Your IFAK is not complete without cravats

  • Posted by Mike Shertz MD/18D
  • Categories Equipment

Cravats as Improvised Tourniquets

🕖 Reading Time,  5 minutes

As a Special Forces medic serving in the late eighties and nineties, an improvised tourniquet was our planned option, should the need for a tourniquet arise. At that time, commercially proven, off the shelf tourniquets did not exist. We trained to use the “stick and rag” improvised cravat tourniquet, as it was really the only good option.

An improvise tourniquet properly applied high and tight on a thigh

Other Uses for Cravats

The classic military triangular bandage, or cravat, is made of muslin cotton in a subdued color. It is a multi-use medical item that can be used as:

  • a sling,
  • to secure splints,
  • form a pressure dressing,
  • create a tight bandage over a gauze packed wound,
  • or even be used as an improvised tourniquet.

Additionally, the cravats come packaged with two large safety pins, which have many other uses.  See, Versatile Safety Pins

Sourcing Cravats

There are civilian/EMS counterparts to the military cravat/triangular bandage. However, in general they are made of substantially cheaper material, their safety pins are smaller and weaker, and they are therefore are overall less useful.

Having taught TCCC classes since Dr. Butler’s article was first published in 1996, we routinely taught students how to effectively use this improvised tourniquet because no commercial tourniquet existed.  Although now surpassed by more efficacious, proven, commercial tourniquets, the cravat tourniquet still has a role when planning medical care in-depth. Eventually, you may run out of commercial tourniquets and have to come up with another option.

The military cravat is a robust addition to your IFAK due to its versatility.

For decades, we recommended actual military cravats over their civilian counterparts. The military cravats were made of stronger material and were higher quality. Of course, the increase in quality made them more expensive than the 79-cent civilian counterparts. Additionally, we had a sense the cheaper cravats wouldn’t make adequately tight improvised tourniquets without tearing and ripping apart.

cravats used to secure wound packing bandages consisting of kerlix gauze and ETD

 Military suppliers being as they are, in 2013 we experienced multiple, recent manufacture, military cravats that could not be made into adequately tight improvised tourniquets. They were too short. Measuring the actual size of the current military cravat revealed it was several inches smaller than the specified size listed on the package. Despite trying several lots of new, actual military cravats, the problem persisted.

Inadequacy of Current Cravats

Lacking a good improvised tourniquet cravat to recommend to students, we tested over twenty “cheap” civilian EMS cravats purchased from all over the world. Surprisingly, all made adequate improvised tourniquets as verified by Doppler ultrasound on my 23.5-inch thighs. We had a similar experience with these cheap cravats on students. See, 12/12 Improvised tourniquets successful.

Unfortunately, the cheap civilian cravats are flimsy and considerably more uncomfortable as improvised tourniquets. Additionally, they don’t do nearly as good of a job forming a tight wound packing bandage. We suspect this is because they have some stretch to them, compared to their military counterparts.  This left us without a “Goldilocks” option of one cravat that could adequately perform all cravat tasks and be “just right.”

Chinook Medical's Oversized Cravat

Recently we discovered Chinook Medical is making an oversized military cravat.  The traditional military cravat specs are 37 x 37 x 52 inches, however, most recently produced are much smaller. The first Gulf War vintage versions were the correct size and worked well for all the uses of a cravat. The Chinook version is 46 x 46 x 65 inches. They describe it as being bigger to account for placing it over a fully kitted out soldier.

With the introduction of this larger military cravat we once again have a versatile option for a well-manufactured cravat. If you just can’t bear to spend the extra money on this cravat and opt for the cheaper EMS version, make sure to get the larger 40 x 40 x 56-inch version.  Again though, it is not nearly as useful as a wound-packing bandage.

a package with clear wrapping labeled cravat, triangular bandage

Each item in an Individual First Aid Kit must either have a clear, proven, life-saving role or be an extremely versatile item that supports your casualty management plan. A cravat clearly meets that latter definition. We pack each of our IFAKs with two appropriately sized military cravats.

A card showing cravats used as a sling

Note: Crisis Medicine is not affiliated with Chinook Medical and does not receive any compensation from them for this opinion/gear recommendation for our students.

Mike Shertz MD/18D

Dr. Mike Shertz is the Owner and Lead Instructor at Crisis Medicine. Dr. Shertz is a dual-boarded Emergency Medicine and EMS physician, having spent over 30 years gaining the experience and insight to create and provide his comprehensive, science-informed, training to better prepare everyday citizens, law enforcement, EMS, and the military to manage casualties and wounded in high-risk environments. Drawing on his prior experience as an Army Special Forces medic (18D), two decades as an armed, embedded tactical medic on a regional SWAT team, and as a Fire Service and EMS medical director.

Using a combination of current and historical events, Dr. Shertz’s lectures include relevant, illustrative photos, as well as hands-on demonstrations to demystify the how, why, when to use each emergency medical procedure you need to become a Force Multiplier for Good.

Previous post

Improvised Tourniquets: Good to have an alternate plan

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Gear Mongering: Why Stop the Bleed is becoming big business 

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