Imagine yourself in a life-or-death scenario where someone is bleeding profusely due to a severe limb injury. In such life-changing moments, being aware of when and how to use a tourniquet can literally save a life or be left standing doing nothing. Being first aid trained, particularly in tourniquet application, sets you ready to act quickly when every second counts.
Learning About Tourniquets
A tourniquet is a medical device designed to avoid excessive bleeding by constricting blood vessels in an injured limb (arm or leg). Its primary function is to control life-threatening bleeding until professional medical assistance arrives. Emergency medical technicians emphasize that tourniquets should only be applied as a last resort following direct pressure and other measures, as they are harmful.
Types of Tourniquets
If there is copious blood loss, it is necessary to have the equipment available to apply direct pressure. Commercial tourniquets are included in most first aid kits transported by health professionals, but improvised tourniquets can also be employed in an emergency situation.
Commercial Tourniquets
Commercial tourniquets are specially crafted medical devices applied for immediate bleeding control. They are typically made of rigid materials such as nylon or elastic straps with mechanical locking devices to provide stability when applied. Unlike improvised models, commercial tourniquets are designed with quick-release systems to allow use once medical assistance becomes available. Commercial tourniquet brands such as the Combat Application Tourniquet (CAT), the SOF Tactical Tourniquet (SOFTT), and the Emergency Bandage, or the Israeli bandage, are popular.
Improvised Tourniquets
In situations where a commercial tourniquet is not available, an improvised tourniquet can be used as an interim measure. Daily-use items like belts, ropes, garments, or sticks can be improvised to form a tourniquet to impede blood flow. Improvised tourniquets tend to be less effective and reliable than commercial ones. They can however only be used until the moment a proper medical-grade tourniquet is available.
When to Use a Tourniquet
Last Resort Option
Uncontrolled hemorrhage is life-threatening within seconds, yet tourniquets are never the first way of controlling bleeding. Direct pressure is always the initial best way of managing massive bleeding. However, if the bleeding does not stop or if the wound is too large to be managed using direct pressure, a tourniquet may become unavoidable. The following are important scenarios that may require tourniquet application:
- Profuse or Uncontrolled Bleeding of a Limb: Where arterial bleeding occurs, which can be defined as bright red spouting blood or oozing heavy bleeding uncontrolled by pressure, an instantaneous action involving the use of a tourniquet must be initiated.
- Severe Lacerations, Puncture Wound, or Amputation: In the case where a large trauma to the limb results in rapid blood loss and direct pressure is ineffective, the tourniquet can be applied to end life-threatening exsanguination.
- Remote or Tactical Situations: When expert medical assistance is not readily at hand—like in wilderness environments, areas of disaster, or combat—the tourniquet can be lifesaving by avoiding further loss of blood until evacuation becomes feasible.
How to Use a Tourniquet Properly
Understanding how to use a tourniquet correctly is as important as understanding when to use one. Tourniquets must be applied tightly enough to stop the bleeding but not so tightly that they cause more harm. To use effectively, do the following:
- Position the tourniquet: Position the tourniquet approximately 2–4 inches (5–10 cm) from the wound. Where an injury overlaps a joint, apply the tourniquet above the joint to best compress the blood vessels.
- Secure Tourniquet: Wind securely around the limb with the tourniquet and clamp per instructions (for commercially manufactured tourniquets) or twist per improvised technique.
- Tighten until Bleeding Ceases: Tighten the tourniquet to the degree that it prevents blood from circulating. If there is still bleeding, tighten the tourniquet further.
- Check the Patient: Verify that bleeding has stopped. If bleeding persists, reposition and tighten the tourniquet again.
- Document the Application Time: Record the exact time the tourniquet was applied. This is vital information for medical staff, since prolonged tourniquet use can cause problems.
The following video is an American Red Cross tutorial on how to use a tourniquet to control life-threatening injuries.
Register for CPR or First Aid Training
Potential Risks and Considerations
Tourniquets work extremely well to control gross bleeding, but should only be applied where it is absolutely necessary because they do carry some risk, including:
- Nerve Damage: Excessive or prolonged pressure on a limb may result in nerve damage, leading to numbness, tingling, or even permanent loss of sensation.
- Limb Ischemia and Tissue Damage: A tourniquet applied for too long can cut off the limb’s oxygen supply, causing tissue damage and, in extreme cases, permanent damage or loss of a limb.
Tourniquets should always be applied with caution and removed as soon as possible professional medical care is available to prevent unnecessary complications.
Statistics and Metrics in the United States
Understanding the epidemiology and circumstances that require use of a tourniquet underscores proper training and readiness.
Emergency Department Visits Involving Tourniquet Use
While there are few detailed national data available on emergency department (ED) visits with tourniquet use specifically, evidence indicates that tourniquet use, while critical in some cases, is not highly prevalent in civilian settings. For example, a civilian extremity trauma study found that tourniquets were applied in 50.6% of the cases in the prehospital setting, 39.1% in the emergency department, and 10.3% in the operating room.
Common Accidents in California Requiring Tourniquet Application
In California, common causes of severe limb injuries requiring a tourniquet include:
- Motor vehicle accidents: High-speed collisions often result in severe limb injuries.
- Industrial and construction site accidents: Heavy machinery and power tools can cause severe lacerations and amputations.
- Violent incidents: Gunshot wounds and knife-related injuries are frequent causes of severe bleeding.
- Outdoor and wilderness accidents: Hikers, climbers, and campers may suffer injuries in remote locations where immediate medical help is not available.
First Aid Instruction For Tourniquet Usage
In today’s unpredictable world, it is always safe to be ready for emergencies. The know-how to react in life-threatening situations is all that might be between saving a life and making matters worse. To learn how to apply a tourniquet correctly is only possible through intensive first aid training.
An investment in first aid training allows one to acquire life-saving skills and knowledge. Practical instruction imparts useful lessons about when and under what situations a tourniquet should be used and under what circumstances another method will prove more effective. Students are taught proper usage methods, possible dangers, and quick-and-sure movement when acting on an emergency. Not only does personal preparedness increase through having first aid training, but it also equips one with the ability to enable others to save lives.
For those who want to acquire professional first aid training, Coast2Coast First Aid and Safety offers professional courses in Los Angeles and has also recently established a branch in Long Beach, CA. Their courses offer hands-on experience and certification in lifesaving techniques, including the use of tourniquets.
A Key Skill for Emergencies
Knowing how and when to apply a tourniquet is an important skill that can be a lifesaver in the event of an emergency. As a medical practitioner, first responder, or a regular person, having this life-saving skill can be the difference between life and death in an emergency.
