Applying a tourniquet over a cut or wound can help slow or limit excessive bleeding in an emergency. A healthcare professional may also precede essential medical procedures, such as A tourniquet may be used, for example, to draw blood or place an IV line, or to reduce blood flow during an operation.
Knowing how to use tourniquets properly is important as there are several mistakes people can make that can reduce the tourniquet’s effectiveness or damage nerves and blood vessels.
In this article, we explain when to put on a tourniquet, how to put it on, and how to craft a tourniquet from everyday items. We’ll also look at common mistakes to avoid and what to do when a tourniquet doesn’t help.
People can use tourniquets in emergency situations to slow or stop excessive bleeding. They put pressure on blood vessels, limiting how much blood can flow through them.
Use a tourniquet when pressure from hands or bandages does not significantly slow or stop excessive bleeding. People should also use a tourniquet if a person:
- lost a lot of blood
- spurting or pulsing blood
- a deep or large wound
- multiple sources of bleeding or wounds
- lost consciousness during the bleeding
Avoid using tourniquets, or use them with caution, if the person:
If a bystander puts on a tourniquet and does not know if a person has these conditions, or cannot find out because they are unconscious, they should still use a tourniquet if no other means of stopping the bleeding work.
Typically, people use tourniquets on their arms or legs. In extreme cases, it may be appropriate to place a tourniquet around the torso. A person can apply a tourniquet whether a person is conscious or unconscious.
Before applying a tourniquet in an emergency, it is important to call 911. People who bleed profusely enough to warrant a tourniquet need immediate medical attention.
It may also be necessary:
- get the person to safety
- Help them sit or lie down
- put something soft under your head
- remove dangerous objects from the immediate vicinity
In emergency situations, the best type of tourniquet is one with a windlass. A windlass is a winch-like rod that helps tighten the tourniquet.
Most capstan medical tourniquets consist of flattened fabric or plastic bands with a clasp or buckle, a capstan, and a clip to hold the capstan.
The American College of Surgeons provides the following demonstration of using a tourniquet:
As per the Stop the Bleed (STB) initiative, there are seven basic steps to follow when applying a windlass tourniquet.
Find the source of the bleeding. Look where most of the blood is and try to follow it to the source. If this is difficult, try asking the person where they feel the most pain, or if they feel any throbbing, tingling, or numbness anywhere.
Expose source of bleeding by tearing or removing clothing. If there are multiple sources of bleeding, work on the most important source first.
After exposing the area, use a clean cloth or gauze to press on or just above the bleeding as firmly as possible. If none of these items are available, apply pressure with a hand, knee, elbow, or whatever is accessible.
If it is not possible to expose the bleeding source, apply pressure across the obstruction as best you can.
Monitor the wound to see if the bleeding has slowed or stopped. If the bandage or cloth is soaked with blood or the bleeding does not slow down or stop, apply the tourniquet.
Wrap the tourniquet around the affected limb 2-3 inches (5-7.6 cm) above the source of bleeding. Make sure the tourniquet is around a portion of the limb that is between the source of the bleeding and the heart.
For example, if the wound is on the forearm, apply the tourniquet to the upper arm.
If it is not possible to uncover the wound, wrap the tourniquet over the top of clothing. If clothing or other items bunch up when trying to wrap the tourniquet around them, flatten them out as much as possible.
If someone is awake and conscious, tell them that the next step can be very painful.
Clamp the two ends of the tourniquet together with the buckle or clasp, and then pull firmly on the end of the strap to the right of the clasp or buckle.
For instructions on using an improvised tourniquet, see the section below.
Gently rotate the capstan on the tourniquet to the right to further tighten the tourniquet. Rotate the windlass until the bleeding stops.
Once the bleeding substantially slows or stops, secure the windlass by attaching it to the windlass clamp on the tourniquet. If the tourniquet has Velcro, wrap it around the windlass to further secure it.
Record the time by writing on the tourniquet itself or by recording it on a phone or device. A person may want to use a timer to keep track of how long the tourniquet has been on.
Keep monitoring the bleeding. When emergency services arrive, let them know how long the tourniquet has been on.
If a person does not have a medical tourniquet, he can make one from everyday objects. However, it is important to note that people should only do this as a last resort.
First, a person needs something to wrap around the skin, such as:
- a long sock
- Pantyhose, pantyhose or stockings
- a piece of torn cloth or long rags
- a scarf or tie
- a hand towel or tea towel
- Exercise or resistance bands
- wide plastic tube
- an elastic bandage
- a hat or bandana
If possible, the material should be at least 3.8 cm wide. Unless other options are available, do not use a belt.
Wrap the item around a limb a few inches above the source of bleeding and tie a strong knot. To make a homemade tourniquet more effective, build an improvised windlass by inserting a rod-like object into the tourniquet knot and twisting it.
Items that can act as a makeshift windlass include:
- jack handles
- strong sticks
- a closed pocket knife
- large closed scissors
Once the tourniquet is tight enough, secure the makeshift windlass by twisting a rubber band, hair tie, key ring, or piece of cloth around it to keep it in place.
Applying a tourniquet incorrectly can make the tourniquet less effective or even cause nerve or blood vessel damage. Avoid:
- Placement of the tourniquet in an area that is not between the bleeding source and the heart
- Placing the tourniquet around a joint, such as an elbow, wrist, knee, ankle, or shoulder
- Place the tourniquet on or too close to the bleeding source
- Use a tourniquet that is too thin, such as B. a tie, cables, cable ties or thin hoses
- The tourniquet becomes too tight, which can damage nerves and blood vessels, or completely stop blood flow to much of the limb
- Applying a tourniquet to an area covered by heavy clothing or other materials
If the tourniquet doesn’t slow or stop the bleeding, try to get emergency help. Call 911 if you haven’t already, or if possible, ask a bystander to locate a doctor nearby.
Try lifting a wounded limb above heart level. Try to keep the person conscious and stay with them until emergency services arrive.
Once healthcare professionals are present, provide as much detail as possible about the situation, such as: e.g.:
- when the injury occurred or when the bleeding started
- how long the bleeding lasts
- the cause of the injury or bleeding
- the location or extent of additional wounds or injuries
- when someone put on the tourniquet and what effect it had
- how much blood someone has lost
In an emergency, a tourniquet can help reduce or stop excessive bleeding. A doctor or nurse may during procedures such as B. taking blood or inserting an IV line, also use a tourniquet.
Always call 911 first if a person is bleeding excessively. Then apply pressure to stop the bleeding and use a tourniquet if that doesn’t slow the bleeding.
Stay with the person until an ambulance arrives, or help them get to emergency help if an ambulance isn’t available.
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