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When It’s Time For a Tourniquet, Things Are Serious.
A tourniquet is designed to restrict the flow of blood through arteries or veins in the event of significant bleeding that simple pressure and bandages won’t stop. If an injury requires a tourniquet, it’s serious and the blood flow can be life-threatening in as little as 3 to 4 minutes.
In its simplest form, a tourniquet is a strap of cloth or material that is twisted tight above a deep wound to stop bleeding until someone can receive professional, medical treatment. It is a stop-gap measure to buy some time until someone can reach a hospital or doctor. Injuries requiring a tourniquet can rarely be treated at home and often require surgery to repair a severed artery or veins.
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The 4 Types of Tourniquets
Different tourniquets are designed for different medical situations. Some are routine while others are medical emergencies. You don’t need to have all 4 tourniquets on hand. Most are for medical procedures, but an emergency tourniquet should be a definite addition to any first aid kit.
- Surgical Tourniquets
- Emergency Tourniquets
- Rehabilitation Tourniquets
- Venipuncture Tourniquets
1. Surgical Tourniquets
Surgical tourniquets are used during routine surgical procedures to diminish the amount of blood in the part of the body where the surgical procedure is taking place. They are not used for all surgical procedures and are most commonly used when a limb such as an arm or leg is the location of the surgery.
2. Emergency Tourniquets
Emergency tourniquets are used by paramedics, combat medics, or anyone else confronted with an accident resulting in a wound or injury with significant bleeding. There are a variety of options but most are designed to be used quickly and in some instances are designed so someone could use it on themselves without assistance.
They are temporary solutions designed to stem the flow of blood until the injured person can be transported to proper medical treatment. They are sometimes referred to as CAT Tourniquets or Combat Application Tourniquets.
3. Rehabilitation Tourniquets
There is a form of therapy called Blood Flow Restriction Rehabilitation that uses a tourniquet to manage blood flow while rehabilitating damaged muscle tissue. They are sometimes referred to as arm occlusion bands and are highly specialized tourniquets best used by trained professionals in a highly monitored rehabilitation setting.
4. Venipuncture Tourniquets
Also known as Phlebotomy tourniquets this is the most common and simplest tourniquet and you’ve probably encountered it if you’ve ever had blood work done before a routine physical or an IV inserted into your arm. It’s an elastic or rubberized length of material usually wrapped around the upper arm to cause veins to bulge to make it easier for a nurse or medical technician to locate a vein for a blood sample or IV catheter.
The Worst-Case Scenario
The emergency tourniquets or Combat Application Tourniquets are designed for the worst-case scenarios involving emergency medical treatment. Many high-end first aid kits have emergency tourniquets and it’s worth knowing how and when to properly use them.
Tourniquet Emergencies
Any number of injuries can lead to profuse bleeding or the need to restrict blood flow requiring the use of a tourniquet including:
- Gunshot wounds
- Deep, lacerating cuts
- Deep punctures
- Automobile accidents
- Farm and construction accidents
- Snakebite
- Compound fractures
You can also improvise a tourniquet in an emergency but in order to do that effectively you need to understand the tourniquet concept. There’s more to it than tying a rope around an arm or leg and there are some common myths and misconceptions that need to be dispelled.
The Tourniquet Concept
At its basic level, a tourniquet is a strip of cloth or elastic that is tightened with a fulcrum or lever that allows the fabric to be twisted into the muscled tissue on an arm or leg to ultimately constrict an artery or vein.
Tourniquet is a French word derived from the word “tourner” which means “turn.” The turn referred to is the twisting action of the metal bar placed into the fabric folds acting as the fulcrum to bind the tourniquet tight.
The standard recommendation is that a tourniquet be applied a few inches above the wound between the location of the wound and the location of the heart.
Arterial lacerations are deemed the most serious with blood pumping from the wound due to the action of the heart. This is what will cause a person to bleed out resulting in death. In actual fact, anyone who loses 40% of their blood (about 2 pints) will soon die. That’s why the decision to properly apply a tourniquet in cases of extreme bleeding is so important. Many experts stress that a tourniquet should not be loosened once it is tight.
Instructions, Cautions, and Misconceptions
A tourniquet should not be an automatic treatment anytime some is bleeding. There are steps to take with any bleeding wound for treatment that doesn’t require a tourniquet.
- Clean the wound if at all possible.
- If an object is stuck in the wound it’s sometimes recommended that it remain in place because it may be actually restrict further blood flow.
- A bandage should be applied to any bleeding wound. If the bleeding continues, pressure should be applied.
- If the combination of a bandage and pressure fail to stem the flow of blood a tourniquet should be applied.
- It should be strapped to the arm or leg about 2 to 3 inches above the wound.
- The fulcrum should be used to twist it tight until the bleeding appears to stop.
- Bandages should be applied and the injured person taken to an emergency room or clinic for professional medical treatment.
- Do not loosen the tourniquet.
Some cautions show up warning of nerve damage as a result of tourniquet use. The solution is to get the injured person to a hospital as soon as possible. Continuous bleeding will cause more harm quicker than any possible nerve damage.
It’s also highly recommended that you take note of when the tourniquet was applied. That will be the first question a doctor or nurse will ask when treating a bleeding patient with a tourniquet.
How to Improvise an Emergency Tourniquet
It’s fair to say that most of us don’t walk around with a tourniquet in our pocket. If you think about it, how many of us even have a tourniquet in our first aid kits and if we do, have we ever bothered to figure out how they work?
Improvising a tourniquet is a good way to familiarize yourself with the concept. In fact, if you don’t have a tourniquet this may be worth doing just so you can add it to your first aid kit. It’s smart to have a tourniquet on hand. Improvising an actual tourniquet in the midst of an emergency will be nerve-wracking.
MATERIALS:
- A triangular cloth bandage or a triangle of cotton fabric about 2 feet long and 1 foot wide to the pointed tip
- A large nail about 3 to 4 inches in length
ASSEMBLY:
- Fold the triangle of fabric starting at the pointed end in repeated folds about 2 inches wide resulting in a strip of fabric 2 feet long by 2 inches wide.
- Tie the middle of the nail to one end of the fabric. This end of the tourniquet with the nail will always be on the outside of the wrap.
- Tie a loop in the end of the tourniquet strip without the nail.
- To apply, wrap the fabric strip around the limb (we’re using a tree limb for this example) leaving a few inches of the material with the loop protruding from beneath the wraps.
- After the limb is wrapped, insert the nail into the protruding end loop and turn so the fabric twists tight.
- Fold the nail into the wraps and seek professional medical assistance.
In a remote or wilderness situation you could use strips of a T-shirt and a stick as a fulcrum to improvise a tourniquet although finding a medical professional for further treatment may be your greatest challenge.
Things to Remember When Purchasing a Tourniquet
- Look for a CAT or Combat Application Tourniquet. These are designed for emergency use and some are designed to be used by one person without assistance.
- Check the length of the tourniquet. Some are designed for the arm only and will not fit around the circumference of a thigh.
- There are also tourniquets that can be unclipped and joined together with a second tourniquet to increase the circumference for use on upper portions of the leg.
- Consider buying multiple tourniquets. Some are sold in multipacks at a discount. This could not only allow you to extend the length but easily dispose of a bloody tourniquet after use.
A Tourniquet is Worth Having
When you consider that a tourniquet is a piece of first aid equipment that could directly save someone’s life it’s definitely worth having in any first aid kit you own… even if you have to make them yourself.
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