What are Tourniquets?
In the wilderness or on the battlefield, injuries can and will happen. During those early moments after an injury, it’s up to you to tend to the wound well enough to earn you enough time till medical professionals can take over. The most common, and most dangerous, of these injuries you’ll have to deal with is bleeding. While some bleeds can be handled with a bandage or pressure, others require the use of a tourniquet.
Tourniquets as they are today have been in use for well over one-hundred years. From as early as the US Civil War in 1861, soldiers have been carrying tourniquets into combat. The tourniquets of the Civil War were crude, as was the training, resulting in death and limb damage for many of the users. Since then, medical training and torniquets themselves have been improved greatly. The most significant changes have been the addition of the “Spanish windlass” and recording the time when the tourniquet was placed on.
Today, every soldier in the US Army always carries at least two tourniquets on them. Many soldiers carry four tourniquets, one for each limb. Soldiers have started carrying loose tourniquets on their limbs preemptively, while others are given uniforms with the tourniquet already sewn into optimal spots. However, one doesn’t have to be a soldier to carry a tourniquet. Anyone that’s going to be away from civilization for an extended period should carry a tourniquet on them. During the Boston Marathon bombing of 2013, hundreds of citizens were injured by improvised explosives. Twenty-seven of the critically injured were saved thanks to the quick application of a tourniquet. Pre-hospital medical treatment is crucial to one’s health in extreme situations. The tourniquet can ensure that patients make it to medical attention.
How are Tourniquets Used?
There are many kinds of tourniquets on the open market today. While they all differ in small details, the important parts remain the same. They’re wide fabric devices, sometimes with a windlass attached. Tourniquets need to be 2 to 3 inches wide. Too small? They cut into the skin. Too large? They’ll either be loose or ineffective at stopping the bleed. In addition, many tourniquets also come with a rod known as a windlass. These devices have been in circulation since World War I and are crucial to tightening the tourniquet. A loose tourniquet is simply ineffective. It should be noted that you don’t need a professional tourniquet. In the event of an emergency, towels, belts, or even T-shirts can be utilized as tourniquets, with sticks, pens, and pencils operating as the windlass.
Secure. When it comes to applying the tourniquet, you should first determine if it’s even necessary. If the wound stops bleeding after a few minutes, a tourniquet isn’t necessary. However, if the wound is still bleeding after 15 minutes or is bleeding heavily and might be life-threatening, a tourniquet should be applied. Use your best judgement but err on the side of caution. When applying a tourniquet, it should be placed 2 inches above the injury. Apply pressure to the wound and wrap the tourniquet around the injured limb. It should be noted now that tourniquets only work for limbs, such as the arms or legs. Chest wounds or head wounds should be tended to with chest seals or compression bandages. Otherwise, do not place the tourniquet overtop joints and do not have any foreign objects beneath the tourniquet.
Tighten. Once the tourniquet is in place, now comes to tightening it. Secure the tourniquet completely around the limb and tighten. Use a windlass to continue tightening until bleeding stops or is significantly slowed. While rare, it is possible a single tourniquet is not enough for an injury. In these cases, a second tourniquet must be used. Secure the windlass so it doesn’t come undone and loosen the tourniquet. You should not feel a pulse below the tourniquet, or it should be very difficult to find it. If so, the tourniquet is in place correctly.
Record. At this point, the tourniquet is in place and the bleeding has stopped. All is good and safe now, right? Not quite yet. The time the tourniquet was placed on should be recorded. Tourniquets can only be kept on for around two hours before limb and nerve damage begin to set in. Record this on an obvious space, either on the tourniquet itself or on the patient’s limb or forehead. Tourniquets are life-saving medical devices, however, are known to cause extensive damage to limbs from effectively cutting off circulation. Tourniquets should not be kept on for longer than two hours, or when swelling begins to occur above the tourniquet. However, only a medical professional should remove the tourniquet. This shouldn’t be an issue, however. Medical responders, military or civilian, and their response times are so effective and rapid that it’s rare to have a tourniquet on for half their total recommended duration.
Use tourniquets and use them liberally. Quick and proper application of a tourniquet is life-saving and critical to the health of you and anyone you secure a tourniquet to. Practice and ensure you’re ready to secure a tourniquet for when the time comes that you’ll need to.
Sources:
JAMA Patients
Journal of Emergency Medical Services
Very Well Health