Imagine finding yourself in a critical emergency situation where someone’s life is at risk, blood pouring uncontrollably from a severe limb injury. In that decisive moment, knowing when and how to use a tourniquet becomes a matter of life or death. First aid skills can be the difference between saving a life and feeling helpless. In this blog post, we will dive into the crucial topic of tourniquet usage in first aid, unravelling the key indicators, proper application techniques, and the critical decision-making process that can empower you to be a lifesaver when every second counts.
Understanding Tourniquets
You might have seen them in movies, but do you really know what a tourniquet is? According to the Canadian Red Cross guide, a tourniquet is a medical device that can be placed around an extremity (arm or leg) to control severe bleeding in emergencies. The main objective of a tourniquet is to constrict or compress a blood vessel to stop life-threatening bleeding until the person can receive appropriate medical care. It is essential to point out that EMR professionals sustain that tourniquets should only be used as a last resource when direct pressure and other methods have failed to control bleeding, as the application of this medical device has potential risks.Types of tourniquets
In emergencies where the victim suffers from severe bleeding, having the right tools can make all the difference. Medical responders usually have commercial tourniquets within their first aid kits, but there are also some improvised options that first aiders could use to help an individual.- Commercial Tourniquets:
- Improvised Tourniquets:
When to use a Tourniquet?
Last Resource
Bleeding emergencies can escalate in a matter of seconds, but an important note you must remember when facing one is that tourniquets are not the initial method for managing bleeding. In most cases, applying direct pressure is the first step in controlling life-threatening external bleeding. At the same time, tourniquets are the last resource when the bleeding is uncontrollable or the severity or location of the injury requires a tourniquet. It is essential for a first aider to identify when to use tourniquets; here are some examples that will help you in the assessment of the environment and patient;
- Profuse or uncontrollable bleeding of a limb:
There are some situations where the bleeding becomes uncontrollable. This could be due to arterial bleeding, characterized by bright red, spurting blood or a continuous flow of blood that can not be controlled with manual compression.
- Life-threatening injuries where bleeding cannot be controlled by direct pressure:
A tourniquet may be necessary if the individual faces a severe laceration, puncture wound, or amputation, and direct pressure becomes ineffective in controlling the bleeding. The injury involves significant blood loss in these emergencies, and a tourniquet can prevent exsanguination. Rapid and significant blood loss can lead to hypovolemic shock, which causes inadequate perfusion of vital organs and tissues. This can be identified as pale skin, rapid pulse and altered mental status.
- Injuries in remote or tactical environments where immediate medical assistance is not available:
Suppose the emergency is located in a wilderness area, combat zone or other scenarios where the injured individual is far from professional medical assistance. In that case, the use of a tourniquet may be warranted. A tourniquet can help buy time and prevent life-threatening bleeding until the patient is evacuated to a medical facility.
Applying a Tourniquet
Knowing how to apply a tourniquet is as vital as learning when to use one. Tourniquets should always be used cautiously by trained first aiders because their application can have potential risks and complications.
Step-by-step instructions to apply a tourniquet correctly
- Identify the site for tourniquet placement: It is crucial to position the tourniquet proximate to the bleeding injury. It should generally be placed approximately 5 to 10 cm (2-4 inches) above the wound. If there is a joint, apply the tourniquet above it and at least 2.5 cm (1 inch) away from the joint. This ensures that the tourniquet effectively compresses the major blood vessels that can stop the bleeding.
- Securing the tourniquet tightly but not excessively: Once it is positioned correctly, tighten it until the bleeding stops. The goal is to apply pressure to occlude the blood vessels without causing damage or excessive pain.
- Checking for cessation of bleeding after applying the tourniquet: After the tourniquet is applied, check if the bleeding has completely stopped and monitor the area.
- Document the time of application: It is crucial to write down the time of application for medical professionals to know how to proceed with the injury, assess the duration of tourniquet use and make informed decisions regarding its removal or potential complications.
Potential Risks and Limitations
As mentioned before, the use of tourniquets should be limited for trained first aiders and as a last resource when other methods for bleeding control become ineffective. After the assessment of the emergency, the first aider will determine if the benefits of the tourniquet overlap the potential risks associated with its use.
Besides all the pros tourniquets have in controlling severe bleeding, it is well known that they may cause nerve damage, limb ischemia and tissue damage.
- Nerve Damage: A tourniquet’s prolonged and excessive pressure can lead to nerve damage. If the tourniquet is applied directly over a nerve bundle or joint, the individual may face numbness, tingling, or permanent nerve injury.
- Limb ischemia and tissue damage: If the tourniquet is left in place for an extended period, it may lead to limb ischemia (inadequate blood supply), and prolonged ischemia can cause tissue damage, leading to muscle and nerve call death. Therefore, tourniquets should be minimized until medical assistance is available.
First Aid Training for Tourniquet use
In today’s unpredictable world, being prepared for emergencies is very important. Understanding how to respond effectively in critical moments can mean the difference between saving a life or exacerbating a situation. The proper use of tourniquets goes hand in hand with comprehensive first-aid training.
Investing in first aid training equips yourself and those around you with life-saving skills and knowledge. Through intensive and hands-on training, you will learn when to use a tourniquet and when to use other techniques. You will understand the indications, correct application, and potential risks involved. Plus, you will gain the confidence to act swiftly and decisively in an emergency.
