How to use an extremity tourniquet

How to use an extremity tourniquet: useful tips

During a war where death lurks at every moment, a medical tourniquet has become for the soldiers of the Armed Forces of Ukraine and civilians who are subjected to daily attacks by drones and missiles, not just a means of providing emergency care, but a symbol of faith that life can be defended even in extreme situations. If you know how to use a tourniquet, you can always buy time and wait for qualified medical care.

Medical tourniquets have proven their ability to save the lives of soldiers who are bleeding. When large vessels rupture, death can occur in just 3 minutes if the blood flow in the damaged limb is not stopped in time. However, you need to know exactly how to use a tourniquet, since not every limb wound requires a tourniquet. One of the most important aspects of controlling life-threatening bleeding from the limbs with tourniquets is determining what degree of bleeding requires this intervention and what does not.

Abundant data from military medics has shown that tourniquets are often used when they are not medically indicated. Not knowing how to use a tourniquet can turn a life-saving device into a negative factor, causing the injured person to lose an arm or leg due to delayed evacuation and time taken to provide qualified medical care. Not knowing how to use a tourniquet can lead to acute kidney injury and a host of metabolic disorders called prolonged tourniquet syndrome.

How to use a tourniquet: basic knowledge

A device that is placed on a limb to create pressure to stop blood flow to an injured area of ​​the body. It is used in emergency situations when other methods of stopping bleeding (such as bandaging or pressure) are ineffective, as well as in traumatic amputations of a limb. A tourniquet consists of a strap that wraps around the limb and a mechanism that tightens the strap until the bleeding stops.

Knowing exactly how to use a tourniquet can be crucial in saving the life and health of a victim. Proper use of a tourniquet involves several key steps:

1. Determining the place of application. It is applied to the limb above the wound (for example, on the thigh or shoulder), without affecting the joints.
2. Application. The tourniquet should be applied tightly, but not excessively. It should stop blood circulation, but not damage the tissues. It is important to fix the device so that it does not slip.
3. Regular check. It is important to monitor the condition of the victim: after 20 minutes, the pressure on the injured limb must be relaxed for a few seconds to avoid tissue necrosis.
4. Time mark. It is necessary to leave a mark about the tourniquet application time. This will help doctors understand how long the blood flow in the limb was stopped.

It is important to understand that the tourniquet is a first aid tool that should be used until the victim gets qualified medical aid.

How to use a tourniquet: the history of the training program

In the early 1990s, doctors were strongly opposed to the use of harnesses at the stage of pre-hospital aid in both the military and civilian sector. Only according to the analysis of combat wounds from 1992 to 1996, the Biomedical Studies Program of the US Navy found that rapid blood loss as a result of limb wounds was the main cause of the death of soldiers that could be prevented. This conclusion recommended the widespread use oftourniquet to stop severe bleeding.

In 2004, as a result of the fighting in Afghanistan and Iraq, the US Army Surgical Research Institute found that many cases of the death of soldiers could have been turned away if this medical accessory had been used in a timely manner. This conclusion has led to a rapid deployment of tactical medicine curricula, including a course on how to use the tourniquet.

The active use of tourniquets on the battlefield has led to a decrease in the number of deaths from blood loss. In 2013, these devices were recommended for use in the civilian sector, and in order to increase the number of doctors, rescuers, firefighters and ordinary citizens who know how to use a tourniquet, the Stop the Bleed program was developed.

The courses on stopping severe bleeding soon became international. The program was supplemented with high-quality illustrations and text descriptions, with the help of which the trainees learned how to recognize life-threatening bleeding from a limb and how to use a tourniquet in various cases:

1. There is gushing, pulsating, or constant bleeding from the wound.
2. A pool of blood is spreading under the casualty.
3. The sleeve or trouser leg is completely soaked with blood.
4. The bandages are ineffective and quickly get wet.
5. The casualty's arm or leg is severed.
6. The casualty is in shock (unconscious, confused, pale) due to the blood loss.

The practice of using tourniquets has shown that simply knowing how to use a tourniquet is not enough to successfully save the wounded. An equally important factor is the rapid evacuation of the wounded with a tourniquet applied to a rear hospital. The issue turned out to be so serious that it was resolved at the level of the US Secretary of Defense. An order was issued according to which the wounded with a tourniquet applied were to be evacuated to the hospital within 1 hour. This prevented cases of limb amputation due to ischemia caused by a prolonged cessation of blood circulation in the injured arm or leg.