Tourniquet Tips: How to avoid mistakes

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    Hey, I thought this might be a fun topic. 😀

    According to the Defense Health Board Memorandum, August 2009, hemorrhage is the leading cause of death on the battlefield and the second leading cause of death in U.S. trauma centers. (The number one cause: being death by reading too many statistics 😉 j/k).

    Dr. Frank Butler Jr., MD, Retired US Navy Captain and Chairman of the Committee on Tactical Combat Casualty Care, states that “Although tourniquet use has been discouraged by civilian EMS systems in the past because of concern about nerve compression and ischemic damage to the extremity, this has not been found to be a significant problem when tourniquets have been used appropriately during combat operations.”

    So here are a few basic tourniquet tips:

    A.Tourniquets are relatively safe if left on for less than 2 hours. Damage is rare if < 2 hours.
    B. Massive hemorrhage: it is better to accept the small risk of damage to then limb then to allow the person to bleed to death.
    C.Tourniquet release should be combined with direct pressure to minimize additional blood loss.

    The CTCCC has listed Six Major Tourniquet Mistakes that should be avoided:

    1. Not using a tourniquet when it should be used. After direct pressure, artery compression, and hemostatic methods are ineffective.

    2. Using a tourniquet when it should not be used. When the hemorrhage can easily be stopped with less invasive measures. Refer to my wound care post.

    3. Putting the tourniquet on too proximally. The tourniquet should be placed high on the limb, but if it is an ankle wound, the tourniquet should not be placed at the inner thigh.

    4. Not tightening the tourniquet enough.

    5. Not taking the tourniquet off when possible.
    Preferably before 2 hours.

    6. Periodically loosening the tourniquet to allow intermittent blood flow. Some books suggest loosening the tourniquet every 15 minutes, but this has been ruled an unfavorable technique by the CTCCC.

    I’m going to a seventh mistake to this list, because believe it or not, it does happen:

    7. Don’t use a tourniquet in event of a head wound. Tourniquets around the neck are not associated with very good outcome…. 😉 They are not very conducive to life. 😉

    Please refer to the following site for correct application of a tourniquet:

    Here is another reference for Tactical Combat Casualty Care:–2.shtml

    May you enjoy all the fun that tourniquets have to offer.

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