Travis Olander 02.02.23
We’ve lined methods to put collectively a correct Individual First Aid Kit (IFAK). One staple of any good package is a tourniquet. This live-saving piece of metal and material is used to cease arterial bleeding in extremities subjected to extreme trauma. A tourniquet can come in useful nearly wherever, anytime: From a gunshot wound, an automotive or leisure automobile accident, a office harm, or perhaps a steep fall on a hike. But, making use of a tourniquet isn’t so simple as throwing the band round a limb, cinching it down, and calling it a day.
Applying a tourniquet incorrectly can result in demise. If you ever end up in an emergency scenario requiring a tourniquet, you’re most likely going to be beneath excessive stress. Mistakes can be simple to make and troublesome to repair. So, let’s go over methods to correctly apply a tourniquet and, extra importantly, cowl what you shouldn’t do when stopping a extreme bleed.
Determine if a Tourniquet is Needed
Tourniquets may cause everlasting tissue and vessel harm. In excessive circumstances, that might imply amputation of a limb is the price of saving that life. A tourniquet shouldn’t be utilized to a wound that’s superficial, or one which primarily impacts fascia (that’s pores and skin, fats, and subcutaneous tissue). If a non-arterial bleed might be stopped with mild stress, then it’s greatest to depend on clotting brokers and a stress dressing.
Importantly, you must air on the aspect of software if you happen to aren’t educated. A tourniquet is unlikely to result in amputation. This solely happens if it’s left in place for hours, so this could by no means issue into your determination to use one. It’s higher to lose a limb than a life.
If you’re witnessing a extreme laceration, if the injured is struggling to stay acutely aware or seems to be in shock, or if you happen to see heavy bleeding that’s vibrant pink and bubbly, it’s time for a tourniquet. If unsure, clamp it down.
Don’t Apply Over Clothing Unless Necessary
We lined why a great pair of trauma shears ought to accompany each IFAK: Clothing needs to be faraway from the location of a bleed to show the harm and surrounding limb. Tourniquets are more practical when not positioned atop clothes. Heavy articles, like denims and jackets, can inhibit a tourniquet’s capability to cease the bleed.
Don’t Apply a Tourniquet Near Joints
Applying a tourniquet close to a joint does two issues: It permits the bleed to proceed, and it raises the danger of inflicting additional harm to surrounding vessels and tissue. Apply the tourniquet at 3″ to 4″ above the affected joint. This ensures tendons and bone don’t inhibit the stress wanted to clamp arteries.
Don’t Apply a Tourniquet Atop The Wound
This might look like widespread sense, however it falls beneath the class of, “This needs to be explained because it’s happened before.” Never apply a tourniquet straight atop a bleed. This received’t successfully clamp arteries. Heavy bleeding will proceed with the added bother of the improperly utilized tourniquet now additionally forcing blood from the distal finish of the limb again into the open wound. Follow the identical rule as with joints: Always apply a tourniquet not less than 3″ to 4″ above the location of the bleed.
If In Doubt, Apply It Higher
Traumatic accidents are messy. An injured limb might need a number of wounds, all of them bleeding to some extent. If you’re unsure about the place arterial bleeding is happening, apply the tourniquet as excessive as attainable on the affected limb.
If a Tourniquet Fails, Apply Another
Severe trauma – like a partial amputation or crushed limb – will end in excessive hemorrhaging. Even a correctly utilized tourniquet might fail to clamp all vessels. If that happens, or if a tourniquet fails after a time frame, apply a second one greater up the limb. Space the second software not less than 1″ to 2″ greater to permit the windlass to maneuver freely. Never take away the primary one, even when one other is utilized.
If Lower Limb Placement Fails, Move to Upper Limb
The decrease halves of the legs and arms every have two bones. In the forearm, we’ve got the Ulna and the Radius. In the calf, we’ve got the Fibula and Tibia. Many first responders say that putting a tourniquet over these decrease extremities can lead to poor stress, as a result of these two bones can forestall arteries from being clamped. This author (who spent years within the army studying about fight tourniquet functions) agrees with this argument. If a tourniquet positioned over the calf or forearm fails, place the second tourniquet excessive up the limb. That means putting it 3″ to 4″ above the knee or elbow.
Use The Windlass (Not the Band) to Stop The Bleed
The windlass is the metallic torsion ring that should be rotated atop the tourniquet to supply enough stress. It isn’t the act of cinching down the strap itself that stops hemorrhaging. The windlass is at all times accountable. That’s why they’re made from metal or stable polymer. Always rotate the windlass till the bleeding stops, after which give it yet another half rotation earlier than securing it.
Don’t Use a Belt Unless You Have To
A belt is just not a great tourniquet. Period. If you’re correctly outfitted – as try to be, because you’re sensible and invested in a high quality IFAK just like the Yellowstone Trauma Kit – then you definitely’ll have a tourniquet accessible. An improvised tourniquet ought to solely be used as a final resort. Even in such circumstances, you must attempt to trend a tourniquet that has an improvised windlass.
Heavy material (like torn denims) might be mixed with any metal or stable metallic merchandise (like a butter knife) appearing as a windlass to supply leverage and stress. If you employ a belt, you’ll must depend on brute power to cinch down the material or leather-based. It’s troublesome to take care of the required quantity of stress with no windlass.
Buy Quality Tourniquets (And Rotate Them)
Two choices come to thoughts: The SOF Tourniquet from TACMED Solutions, and the Combat Application Tourniquet from North American Rescue. These two bleed stoppers have been and proceed to be trusted by regulation enforcement, army, particular operators, and medical responders internationally. Investing in something much less is solely not definitely worth the threat.
Even high-quality gear like these items will fail over time. You do not wish to apply a tourniquet that has dry-rotted material, a damaged or brittle windlass, or seen indicators of tear. Tourniquets don’t have expiry dates, however they need to sometimes be swapped out for brand spanking new items. As lengthy the material and windlass stay dry and free of harm and particles, it’s secure to say they’re good for not less than two years.
