C-A-T helps save farmer's hand

March 27, 2015, was unusually cold, but that didn't stop 62-year-old Randy Therkilsen from working on a broken feed wagon in the machine shop at his Comfrey, Minnesota, farm. Therkilsen, who has a small cow-calf operation in addition to acres of soybeans and corn, was removing a bearing from the shaft when a metal fragment chipped off, lacerating a blood vessel in his right wrist.

By the time Therkilsen climbed down from the equipment, he was bleeding profusely. When applying pressure didn't help, he sent his son for the Combat Application Tourniquet (C-A-T) he kept in his truck. His daughter Maria Flor, a registered nurse and trauma coordinator at the Mayo Clinic Health System clinic in Springfield, Minnesota, had given it to him for Father's Day the year before. Moments after applying the tourniquet, the bleeding stopped.

Therkilsen's family took him to the hospital in Springfield, but he eventually had surgery at Mayo Clinic's campus in Rochester, Minnesota. The shrapnel had lodged close to an artery and needed a hand surgeon to remove it.

Therkilsen, a stoic Midwesterner who underwent a partial amputation after another farm-related accident, recovered full use of his hand. Flor says the tourniquet made the injury less serious so her father required fewer interventions and recovered sooner. "If he had lost more blood, things could have spiraled downward pretty quickly," she says.

Flor knows better than most how quickly injuries involving severe blood loss can turn fatal. "Most injured people who die of blood loss do so within 30 minutes," she says. "Fatal injuries occur on farms across the country each year because people don't have the tools or education to treat them."

Flor has made it her mission to change that — to ensure that every farmer carries a commercial tourniquet and knows how to use it.

Not all in the family

Flor started by giving tourniquets to her dad and brother, but that was just the beginning. Last year, she and volunteers from the southern and southwestern Minnesota trauma regions brought their injury prevention message to Farmfest, an agricultural trade show that draws as many as 40,000 people to tiny Morgan, Minnesota, for three days each August.

This year, they'll be back. "We originally thought this was a one-and-done thing, but now we realize that was totally wrong; we're just at the beginning of where we need to be," Flor says.

In addition to bringing injury awareness to farm families, volunteers from Mayo Clinic and the Southern Minnesota Regional Trauma Advisory Committee (SMRTAC) are offering a free hemorrhagic control course to police officers throughout Minnesota.

"Law enforcement officers are often the first on the scene of a crash, and we want them to have hemostatic products in their toolkit and to know how to use them to help others as well as themselves," Flor explains.

She stresses that purchasing an authentic tourniquet is crucial. Knock-off C-A-Ts and improvised tourniquets — the kind fashioned from a torn T-shirt or sheet — can do more harm than good by damaging tissue, increasing bleeding and even causing limb loss. "Yes, you can order C-A-Ts from Amazon, but be careful who you buy from. Be sure it's the real thing," Flor cautions.

She also stresses that commercial tourniquets are simple to use. "My brother had no training, but it's intuitive, and he figured it out quickly," she says.

Since the accident, Therkilsen keeps the tourniquet close at hand, and has found a bright spot in the experience. Flor remembers him saying, "Maria, this is our story to further our cause."

For more information

Minnesota Farmfest 2015.