A tourniquet is a device designed to apply pressure to a limb, stopping blood flow. This intervention is reserved for severe, life-threatening bleeding from an arm or leg when direct pressure alone is insufficient or impractical. Tourniquets serve as a temporary, life-saving measure to control catastrophic hemorrhage, buying crucial time until professional medical assistance can be obtained.
Understanding Tourniquet Placement
The effectiveness of a tourniquet hinges on its correct placement, which typically follows the principle of “high and tight” or 2-3 inches above the wound. “High and tight” means positioning the tourniquet as far up the injured limb as possible, close to the torso. This placement is useful in chaotic situations or when the precise wound location is unclear, allowing for rapid application.
Placing the tourniquet 2 to 3 inches above the wound is an alternative, especially when the exact bleeding site is identifiable. This method aims to minimize the amount of healthy tissue deprived of blood flow. It is important to avoid placing the tourniquet directly over a joint, such as the elbow or knee. Joints can prevent the tourniquet from effectively compressing major arteries against the bone, which is necessary to halt blood flow. Optimal placement is on a part of the limb where arteries can be compressed, such as the upper arm or thigh.
Step-by-Step Tourniquet Application
Applying a commercial tourniquet correctly ensures it effectively stops bleeding. First, position the tourniquet 2 to 3 inches above the wound, or as high as possible on the limb, directly on the skin if feasible, or over minimal clothing. Next, pull the strap tightly through the buckle, ensuring it is snug around the limb.
Once the strap is tight, twist the windlass rod until the bleeding stops completely. This twisting action increases pressure, compressing the underlying arteries. Continue twisting even if the injured person experiences pain, as sufficient tightness is needed to stop bleeding. Finally, secure the windlass in place using the built-in clip or fastener to prevent it from unwinding, then secure any remaining strap.
Crucial Actions After Tourniquet Application
Immediately after successfully applying a tourniquet and confirming bleeding has stopped, contact emergency medical services (such as 911) without delay. Prompt professional medical attention is necessary, as the tourniquet is a temporary measure. Note the time the tourniquet was applied, either on the tourniquet itself or on the patient’s forehead, using a permanent marker if possible. This information is important for medical personnel to assess the duration of blood flow restriction.
Continuously monitor the patient and wound for any signs of re-bleeding, which could indicate the tourniquet needs further tightening or a second tourniquet just above the first. An important rule is to never remove or loosen a tourniquet once it has been applied and bleeding controlled. Loosening it can lead to further, potentially fatal, blood loss and release accumulated toxins into the bloodstream. Only trained medical professionals in a controlled environment should remove a tourniquet, as they can manage the associated risks.