When it comes to using a tourniquet, it is important to understand that untrained rescuers can easily cause more harm than good. While the efficacy of tourniquets has been debated, it is crucial to attempt targeted direct pressure before resorting to a tourniquet. Most bleeding can be stopped with direct pressure alone, even if it is coming from a large vein or artery. However, if a tourniquet is necessary, it must be used properly to prevent further harm.
Issues pertaining to the application of tourniquets are diverse:
Loose application of the tourniquet: Due to the blockage of the venous return blood flow and the continued passage of arterial blood past the tourniquet, this may worsen the bleeding.
Releasing the tourniquet too quickly: Would restart the extreme bleeding, not only the bleeding will be fatal, but squeezed blood vessels may also be damaged by the blood flow returning to normal.
Overusing the tourniquet: This results in tissue death and neurovascular injury. Leaving it for too long, can cause damage to the nerves, muscles, and blood vessels.
Putting the tourniquet on the incorrect kind of wound (such as wounds at a joint) or too far away from the wound.
Incorrect fabric used to make the tourniquet: Blood pressure cuffs may loosen, and parachute cord may sever skin. The recommended width for tourniquets is between one and two inches. The wider the tourniquet, the more pressure will be required. Commercially available tourniquets such as the CAT (Combat Application Tourniquet, pictured above) are recommended over one improvised out of found materials.
It is also important to apply the tourniquet with as much direct skin contact as possible and to record the time of application for EMS.
When applying a tourniquet, it must completely stop arterial blood flow and larger limbs require more pressure. The width of the tourniquet also affects the required pressure, with wider tourniquets requiring more pressure. It should be placed approximately two inches from the wound and upstream between the wound and the heart. If EMS is delayed, cooling the limb with ice or cold packs may help reduce tissue damage.
Overall, while tourniquets can be life-saving in certain situations, it is important to learn proper tourniquet application to avoid causing further harm. Always attempt targeted direct pressure first and seek professional medical assistance as soon as possible.
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