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How to Apply a Tourniquet

Knowing how to apply a tourniquet correctly could mean the difference between life and death in the critical moments following a severe injury. This simple device, used to limit blood loss from a limb, can be a hero’s tool in a crisis. Whether you’re an adventurer, a caregiver, or someone who believes in being prepared for emergencies, this guide is for you.

What Is a Tourniquet?

A tourniquet is an essential tool employed during urgent circumstances to manage the venous and arterial flow to an extremity (such as an arm or leg). Its purpose is to apply constriction or compression temporarily in order to regulate circulation.The primary function of a tourniquet is to control blood flow and stop severe bleeding, typically in traumatic injuries, and to keep the person stable until further medical assistance can be provided.

Types of Tourniquets

When it comes to tourniquets, it’s important to know that there are different types available. Here, we break down the two main types – improvisational and commercial – to help you understand their features, uses, and benefits.

Improvisational Tourniquets

improvisational tourniquet with cloth and rubber gloves and pen around leg

Improvisational tourniquets are exactly what the name suggests: they’re makeshift tourniquets created using materials you have on hand during an emergency. This could include a bandana, a belt, a piece of cloth, or any flexible and strong material that can be tightened around a limb.

While improvised tourniquets can be effective in a pinch, they’re generally less effective and more potentially damaging than commercial tourniquets. An improvised tourniquet should only be used when nothing else is available and severe bleeding needs to be controlled immediately.

Commercial Tourniquets

Commercial tourniquets are specially designed for the purpose of stopping severe bleeding on an injured limb in an emergency. They’re typically made of strong, durable material and often include a windlass or similar mechanism to allow for precise and strong pressure on blood vessels to limit blood supply.

There are several types of commercial tourniquets available, including:

  • Combat Application Tourniquet (CAT): The CAT is a popular choice in both military and civilian settings. It’s a one-handed tourniquet that uses a windlass system to tighten.
  • Special Operations Forces Tactical Tourniquet (SOFTT): The SOFTT is another military-grade tourniquet. It has a similar design to the CAT but uses a metal windlass, making it a little more robust.
  • Ratcheting Medical Tourniquet (RMT): The RMT uses a ratchet system, allowing for quick and easy application and precise control over pressure.

When Should a Tourniquet Be Used?

A tourniquet is an incredibly valuable tool to stop life-threatening bleeding, but knowing exactly when to use it on an injured person is crucial. While its use can be life-saving, inappropriate or unnecessary application can also lead to complications or damage. Here’s what you need to know:

Identifying the Need for a Tourniquet

Tourniquets are designed to control severe bleeding from an extremity – the arms or legs. This is typically the kind of bleeding that is not easily controlled by more straightforward methods such as applying direct pressure or a pressure bandage.

Here are a few situations where a tourniquet may be necessary:

  • Traumatic injuries with severe bleeding: This includes incidents like car accidents, serious falls, or industrial accidents where there may be deep cuts or crushed limbs.
  • Gunshot or stab wounds: These can cause significant damage to arteries, leading to rapid and severe blood loss.
  • Amputations: If a limb is partially or completely severed, a tourniquet may be needed to control bleeding.

A tourniquet should be used as a last resort for life-threatening bleeding due to limb injuries that other methods cannot control. It should not be used for minor cuts or wounds that are bleeding slowly, only on spurting or pulsating blood wounds.

How to Apply a Tourniquet: A Step-by-Step Guide

Learning to correctly apply a tourniquet can literally save a life in an emergency. Follow these steps carefully:

Identify the Need for a Tourniquet

Before you rush to apply a tourniquet, assess the situation. A tourniquet should only be used for severe, life-threatening bleeding from an arm or leg that cannot be controlled by pressure.

Position the Tourniquet

Once you’ve decided a tourniquet is necessary, you must position it correctly. It should be applied 2-3 inches above the wound but never on a joint (like the knee or elbow). If the wound is on the lower leg or arm and you cannot stop the bleeding, placing the tourniquet above the knee or elbow may be necessary. Try to place it on bare skin, but if clothing must remain, ensure it’s not too thick or bunched up.

Tighten the Tourniquet

Tighten the tourniquet until the bleeding stops. This will likely cause discomfort or even pain, but controlling the bleeding is necessary. If you’re using a windlass-type tourniquet, like a CAT (Combat Application Tourniquet), turn the windlass until the bleeding has stopped, then secure it in place to keep the tourniquet tight. If you’re using a ratchet-style tourniquet, like a SAM XT, pull the strap tight, then engage the ratchet to tighten it further until the bleeding stops.

Mark the Time

As soon as the tourniquet is applied, note or mark the time. This is important information for medical personnel, as a tourniquet should not remain in place for more than two hours, if possible.

Seek Professional Help

Even with a tourniquet in place, getting professional medical help is still absolutely crucial. A tourniquet is a stopgap measure to prevent someone from bleeding to death before reaching a hospital. It isn’t a long-term solution and will likely cause serious injury if left in place for too long.

Storing and Maintaining Tourniquets

It’s not enough to simply own a tourniquet. You need to know how to care for it too. Proper maintenance and storage of your tourniquet can ensure it’s ready to use when you need it most.

Storage Conditions

Tourniquets should be stored in a cool, dry place. Moisture can degrade the material over time, compromising the tourniquet’s effectiveness. Extreme temperatures can also be detrimental, so avoid storing them in direct sunlight or freezing conditions.

If you’re storing a tourniquet in your car, remember that the interior temperature can fluctuate significantly throughout the year. Consider keeping it in a thermal-insulated container to protect it from these temperature changes.

How to Check for Wear and Tear

Regularly inspect your tourniquet for signs of damage or wear. This includes looking for any fraying, tearing, or weakness in the material and ensuring that the buckle or windlass (the rod used for tightening) functions correctly. Any loss of elasticity in the band can also be a sign that it’s time to replace your tourniquet.

If you have a commercial tourniquet, follow the manufacturer’s guidelines for inspection and replacement. These devices are designed for a certain lifespan and must be replaced after that time, even if they haven’t been used.

Saving Lives with Tourniquets

contents of medical pouch

Tourniquets are a key component in first aid and trauma care, potentially saving lives in emergency situations where severe bleeding occurs. Learning how to apply a tourniquet effectively and correctly is a skill that anyone can and should acquire. It’s not a skill that’s solely reserved for medical professionals or adventure seekers; it’s a skill that has practical implications for everyday life.

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