Investigation: Dispatcher tells bystander to remove tourniquet

Bystander with military training used his belt as a tourniquet on a man's severed leg; department policy is to leave tourniquets in place

SAN DIEGO, Calif. — The San Diego Fire-Rescue Department is investigating why a dispatcher instructed bystanders to remove a tourniquet they had applied to a man's severed leg after he had been struck by a motorcycle.

According to the department medical director, the direction to remove a tourniquet goes against department policy, reported NBC7.

The 49-year-old victim was standing in the street when he was struck by a motorcycle. He had multiple serious wounds, including one leg severed below the knee. A witness to the crash, Anthony Rabaya, followed his instincts and military training to use a belt to create a tourniquet.

“I just tried. I didn't think about it. I just reacted,” Rabaya said.

In the 911 recording, a dispatcher can be heard telling the people helping the victim to take off the belt.

Caller: "My boyfriend put a belt around his leg because it's bleeding."

Dispatcher: "OK, all right, so they put a tourniquet on his leg?"

Caller: "Uh, no ... uh, a belt. We've got the belt around because his leg is chopped off."

Dispatcher: "OK, we need to take that belt off. We don't want to tourniquet it."

Caller (talking to boyfriend): "Take the belt off, she says. Take it off."

“I didn't agree with taking the tourniquet off. Come on, it's an amputation,” Rabaya said.

City of San Diego EMS Medical Director Dr. Jim Dunford said to NBC7, "That does in fact run contrary to the way we teach our dispatchers to handle something like that. Leave [the tourniquet] alone until a firefighter can get there and determine whether it should continue to be there."

Firefighters reapplied the tourniquet when they arrived. At that time, the victim was still alive.

“I would be very surprised this brief interval of two or three minutes was responsible for the person's passing,” Dunford told NBC7.

Dunford says he hasn't spoken with the dispatcher to determine how or why she made that decision. The dispatcher will remain on duty during the investigation and all dispatchers will receive in-service training about the tourniquet policy.

In a statement, San Diego Fire Chief Javier Mainar said his department is reviewing the case.

"The Fire Dispatch Center handles 125,000 calls a year. As the Fire Chief, I have confidence in the ability of our dispatchers to handle emergencies efficiently, professionally and appropriately and I want the public to be assured you can have that same confidence." 

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