When and how to use a tourniquet (2023)

turnstilesare tight bands that are tied around an arm or leg to stop bleeding from a serious wound, e.g. B. by a shot to stop. They are used to slow bleeding until emergency care can be provided. Tourniquets can save a limb—or a life—in the event of a trauma or emergency.

Ideally, tourniquets should only be used by first responders trained in first aid. However, knowing how and when to use it is an important life-saving skill.

This article describes when to use tourniquets - and when not to - and the proper way to use this important medical device.

When and how to use a tourniquet (1)

Basic first aid that everyone should know

When to use a tourniquet

Tourniquets, even when used properly, can cause serious tissue damage. However, in the event of a major bleed and a life-or-death emergency, proper use of a tourniquet can stop the bleeding and keep an injured person stable until medical attention can be given.

Emergencies where a non-medical person may use a tourniquet include:

  • car accidents
  • gunshot wounds
  • deep cuts
  • Bruised limbs (e.g. from awork injury)

Most people will never need to use a commercial tourniquet. Still, knowing the proper way to put on a tourniquet can potentially save someone's life.

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What are tourniquets made of?

If you are a first responder or emergency medical professional, you have access to a commercial tourniquet. However, if you are a civilian, you will most likely have to improvise.

In an emergency, you may not be able to get a tourniquet quickly. Instead, you may have to come up with a makeshift tourniquet to control the bleeding.

The most important thing is your own safety. Before providing first aid, make sure it is safe for you to do so.

Research has shown that improvised tourniquets are effective in up to 60% of cases.This may not sound reassuring, but as long as you have the right materials and know how to properly use an improvised tourniquet, any attempt to stop the bleeding is probably better than doing nothing.

A makeshift tourniquet requires two parts: a triangular bandage and something you can use as a windlass rod (such as a pin or stick). Other items you may have on hand that can be used are shirts or towels.

Practice in any emergency—but especially when it comes to bodily fluids like blooduniversal precautions. ifPersonal protective equipment(PPE) is available (such as gloves and masks), put them on before providing first aid.

Do tourniquets donned by civilians help?

A 2018 study found that patients with peripheral vascular injuries or blunt trauma to the extremities were six times less likely to die when civilians without medical training performed prehospital tourniquet application.

(Video) How to use a Tourniquet in an Emergency

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Are tourniquets included in first aid kits?

While they work in an emergency, commercial tourniquets are not available in first aid kits. There are other ways to adequately and safely control bleeding in most injuries; Tourniquets should only be used in worst case scenarios when there are no other options.

However, a commercial tourniquet is preferable to a "homemade" one when available. Commercial tourniquets are made from recommended materials and specifications, making them the most effective and easiest to use. They are also better at minimizing risk when used.

Since yourFirst aid kit for home useIf a tourniquet is not included, you should consider adding one if you are working with or caring for individuals who are at high risk of bleeding injuries or complications from major bleeding, such as: B. small children and the elderly.

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How to put on a tourniquet step by step

You don't need an official or special medical certificate or training to apply an emergency tourniquet, but you do need to know how to use it properly.

The first step in any emergency situation is to call 911. If someone else is with you, point to them and say "Call 911." Then you can start caring for the injured person.

head and trunk injuries

Tourniquets are for limb injuries only. tourniquetscannot be used for head or trunk injuries.An injury to the head or torso requires theapplication of pressurewith a material that can absorb blood to slow or stop bleeding.

The use of a tourniquet is only intended as a stopgap measure to "buy time" while you wait for medical personnel to arrive. If a person is bleeding uncontrollably and there is no help nearby, they may bleed to death before first responders can arrive to provide necessary medical attention.

The goal of applying a tourniquet is to restrict blood flow to the injured limb and prevent life-threatening blood loss. Constricting the limb to cut off the blood supply is a temporary measure, but if done properly, it will slow the bleeding or stop it enough for emergency workers to arrive.

1:38

Click Play to learn how to properly put on a tourniquet

This video has been medically reviewed byAnju Goel, MD, MPH.

(Video) The Hartford Consensus: How to Use a Tourniquet

Step 1: Find the source of the bleeding

Before applying a tourniquet, you need to find out where the bleeding is coming from. In some cases, such as in near or total amputation of a limb, the source of the bleeding is obvious. Other injuries may not be visible at first, especially when debris, debris, shredded clothing, or other objects are in the way.

If possible, have the injured person lie down. This makes it easier for you to have control from head to toe. Try to stay calm and focused. You must find the source of the bleeding as soon as possible.

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Step 2: Apply pressure

Once you've found the source of the bleeding, apply direct pressure to the wound. If the bleeding doesn't slow down or stop when pressure is applied to it, you need to find (or attach) a tourniquet.

If the injured person is awake and alert, tell them you are going to put a tourniquet. You need to know that putting on a tourniquet can be extremely painful (and you're probably already in a lot of pain). Tell the person that the tourniquet will hurt, but may save their limb or even their life.

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Step 3: Position the tourniquet


The tourniquet must be applied to bare skin, so you must cut, tear, or otherwise remove all clothing near the wound.

Next, position the cloth, towel, or other material to be used for the tourniquet a few inches over the injury on the limb.

Place the tourniquet on the part of the limb closest to the heart. For example, if the injury is below the knee or elbow, you need to tie the tourniquet above the joint.

Use a standard square knot — like you use to tie your shoelaces, but without a loop — to tie the tourniquet around the limb.

The American Red Cross recommends placing the tourniquet2 cm above the woundandnever directly on a joint.

Step 4: Add a Windlass

Next you need to make a lever that will allow you to twist the tourniquet tighter. This is referred to as aAnkerwinde.

Anything can be used as a windlass as long as it is strong enough to hold the tourniquet and can be secured in place. For example, pens or pencils, sticks or spoons can be used as windlass.

Place the capstan on the knot, then tie the loose ends of the tourniquet around it with another square knot.

(Video) How To Apply A Tourniquet

Step 5: Tighten the tourniquet

Rotate the windlass to increase pressure. Keep an eye on the bleeding and note when it slows down. Continue turning the windlass until the bleeding has stopped or decreased significantly.

Once the bleeding has slowed or stopped, secure the windlass by tying one or both ends to the injured person's arm or leg.

Are turnstiles controversial?

Step 6: Time it

Tourniquets can be put on for no more than two hours.You must note when you put on the tourniquet. It is very important that first responders and medical personnel treating the injury know when you have applied the tourniquet.

Mark a "T" with the date and time on the person's forehead or some other prominent place. This will ensure rescue personnel know how long the tourniquet has been on.

Do not remove a tourniquet yourself

A tourniquet shouldoh nonot be dislodged or removed by anyone other than a healthcare professional in the emergency room.

Common Tourniquet Mistakes

Even if you know how to use a tourniquet properly, it's possible to make mistakes. In an emergency, you may not have enough help or resources, and you will likely face many distractions.

The following are possible mistakes you can make when using a tourniquet:

  • Waiting too long: You must treat heavy bleeding immediately for a tourniquet to be successful. If an injured person loses too much blood, they can go insideSchock.
  • Loose application: Loose tourniquets are not effective because they do not adequately restrict arterial blood flow.
  • Do not put on a second tourniquet: One tourniquet is usually sufficient to control heavy bleeding, however, a person with large arms may need a second tourniquet.
  • relaxation: The contraction and relaxation of the tourniquet, rather than continuously narrowing it, allows blood to re-enter the injury. If blood flows back to the injury, it can damage blood vessels.
  • Leave on for too long: A tourniquet should not remain in place for more than two hours. With prolonged use, tourniquets can cause lasting damage to muscles, nerves and blood vessels.
  • Using the wrong materials:Unsuitable materials for a tourniquet, e.g. B. a cord, can cut into the skin. Not only does this render the tourniquet ineffective, but it can also cause more pain or injury.

Life Saving First Aid Skills You Should Know

summary

In an emergency, knowing how to use a tourniquet can save an injured person's limb — or even their life. Although it is best for only trained people to apply a tourniquet, anyone can do it if they have the right materials and knowledge.

Remember: the best way to avoid making mistakes when using a tourniquet is to be informed about when and how to use it correctly.

frequently asked Questions

  • What are the two types of tourniquets?

    Tourniquets are sometimes used during medical procedures and surgeries to limit blood flow to a limb. This makes it easier for the surgeons to see what they're doing since there isn't as much blood in the way.

    Tourniquets can also be used to "cut off" the blood supply to a limb in an emergency, to prevent an injured person from losing too much blood.

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  • Is it okay to use a belt as a tourniquet?

    Using a belt as a tourniquet is not ideal. Straps are too stiff to twist tightly with a windlass. Other items that don't work well as a tourniquet are ties (they're too flimsy) and zip ties (likely to cause a lot of pain as wellnerve damage).

  • How long does it take for a tourniquet to permanently damage a limb?

    It takes about two hours for a tourniquet to cause permanent damage, including nerve damage, injury to blood vessels, and skinNecrosis(death of skin cells). After six hours, the damage to muscle tissue can be so severe that it is necessaryamputatethe affected limb.

  • How soon should a tourniquet be applied?

    It's best not to put on a tourniquet right away. First, apply direct pressure to the woundabsorbierendes Materialfor at least 10 minutes. That's how long it takes for the blood to clot and the bleeding to stop. If this is not the case, a tourniquet should be used.

  • Why do phlebotomists use tourniquets for blood draws?

    If youto draw blood, the phlebotomist uses a piece of rubber as a tourniquet. They will apply it briefly (just a few seconds) to your upper arm to locate the vein they are using to draw blood.

Videos

1. Stop The Bleed: Tourniquet Application
(PrepMedic)
2. How to Apply & Tie a Tourniquet When Drawing Blood or Starting an IV
(RegisteredNurseRN)
3. How To Use The SOF® Tactical Tourniquet Wide (SOFTT-W)
(Prometheus Medical)
4. Combat Application Tourniquet (C-A-T) Instructions
(North American Rescue)
5. Stop the Bleed Tourniquet Training
(NorthsideGwinnett)
6. Tourniquet Use
(Fire Engineering)

References

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