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An emergency tourniquet can be a highly effective tool for stopping rapid bleeding from a severe injury. However—while your first-aid kit should include a tourniquet—a tourniquet is no good if you don’t know how to use it.
Why is a Tourniquet Necessary?
Gunshot wounds, stab wounds, and other penetrating ballistic injuries can cause life-threatening blood loss. If you don’t control the bleeding promptly, you or the patient may experience blurred vision, fatigue, loss of consciousness, and death.
You need to apply pressure to the wound to stop the bleeding so that emergency services can arrive and stabilize the patient. Alternatively, if you’re in the field or a warzone, you need to be able to keep your friend or comrade alive until medical evacuation.
Believe it or not, tourniquets have been around for centuries. A tourniquet is a device resembling a cuff, belt, or elastic band that you use to slow bleeding by applying localized pressure on a limb or other extremity above the injury.
The pressure blocks blood flow, stopping or slowing it. There are different types of tourniquets. But the one you should consider for a first-aid or trauma kit is the emergency tourniquet.
Improper or inappropriate application of a tourniquet can cause serious tissue damage, nerve paralysis, and other complications. As a result, it’s critical that you understand how to apply a tourniquet correctly. Using a tourniquet is a last-resort option. If you can control the bleeding in another way, you should.
How to Stop Bleeding
If you or someone else suffers a penetrating injury, such as a puncture or laceration that causes bleeding, you need to slow and stop it. There are several suitable options:
- Cleaning the wound with saline solution
- Patting the wound dry with sterile gauze
- Placing sterile gauze on the wound
- Wrapping the gauze in a compression bandage
- Taping the bandage in place (if necessary)
If further pressure is needed, apply it with your hands.
However, there may be circumstances under which these steps are insufficient or not viable.
How to Apply a Tourniquet
Tourniquets are strictly for injuries to the limbs/extremities. You cannot use a tourniquet on a patient’s head or torso.
The tourniquet’s purpose is to restrict blood flow to the injured limb, slowing the bleeding until emergency medical personnel can arrive on the scene. You should be aware that if the patient is bleeding profusely — especially from multiple wounds — they may exsanguinate before an ambulance arrives.
Before you can apply a tourniquet, you need to determine the location of the injury. If the patient’s arm or hand has been cleanly severed, it won’t take long.
However, if the patient is lying on the ground and covering the wound, you will have to quickly assess the individual. If applying direct pressure to the wound fails to stop or slow the blood loss, or the bleeding rate is high, you will need to fasten a tourniquet to the injured limb.
Apply above the injury
You should wrap the tourniquet around the limb above the injury and as close to the heart as possible. If, for example, the wound is below a joint, place the tourniquet above it.
Emergency tourniquets use a device called a windlass to further constrict blood flow. This is a metal bar or handle that allows you to tighten the tourniquet by twisting it, creating a mechanical advantage.
The circulatory system operates under high pressure, so you need to fasten the tourniquet snugly. In improvised examples, a stick or rod may substitute for a windlass. Continue twisting the windlass until the bleeding stops or significantly slows, constantly monitoring the blood flow. Once you’ve twisted it to the desired tightness, lock it in that position.
Note the time
If possible, note when you applied a tourniquet. A tourniquet shouldn’t be applied for prolonged periods, so detailing when you applied it will assist emergency medical personnel.
What Not to Do
There are a few actions that you should avoid when applying a tourniquet to an injured individual. Improper use of a tourniquet can render it partially or completely ineffective. It can also increase injury.
Don’t use a cord
A makeshift tourniquet with a narrow cross-section may cut into the skin under tension, causing additional injury and discomfort. The tourniquet must be wide enough to distribute the pressure over a wider area, which is why dedicated emergency tourniquets are wide constricting bands.
One substitute for a dedicated tourniquet that you’ll sometimes see is surgical tubing. This, combined with a makeshift windlass, can do the trick in a pinch. Alternatively, a t-shirt may also work.
Don’t loosen the tourniquet
If you apply a tourniquet to a severely injured individual, you did so to stop life-threatening blood loss. Don’t loosen it prematurely — only trained medical personnel should do that under the correct conditions.
Don’t wait too long
If a tourniquet is necessary, it’s a matter of life and death. Yes, you should use other methods first; if you can, once you determine that a tourniquet is necessary, apply it immediately. The longer you wait, the more likely the patient is to lose consciousness.
Don’t apply it too loosely
The tourniquet should stop the bleeding. If you don’t fasten it tightly enough, it may slow the bleeding but not stop it, risking the patient’s health.
Don’t leave the tourniquet on too long
While it’s possible to remove a tourniquet prematurely, it’s also possible to leave it on too long. A tourniquet should not be fastened for more than two hours. The longer it stays on, the higher the risk of complications.
Where to Go From Here
Understanding how to use a tourniquet in an emergency is a valuable life skill. But it’s only one of several components.
If you can, consider taking a first-aid course. You don’t need to be trained in field surgery or trauma medicine. But understanding how to treat both minor and life-threatening injuries is a skill every responsible citizen should possess.
The Take-home Message
With the right mindset and knowledge, you can be prepared to save someone’s life in an emergency. Having the right skills can help you keep your head and make the best decisions in stressful situations.