Yes, they’re back in the First Aid Book once again. (Remember as always, we are a Canadian Training Company – your country may have different rules!) The use of tourniquets is always a source of debate in First Aid Training. They certainly save lives, but there are downsides too. So let’s take a look.
Tourniquets – Life Savers
Tourniquets save lives. There is no question that in the case of life-threatening bleeding, if you can’t stop the person bleeding by any other means then their use is justified to prevent the person dying. The current First Aid training is to use one if:
- The bleeding cannot be controlled
- You are unable to reach the wound to stop the bleeding
- You must move the person in such a way that pressure cannot be maintained by other means.
Are they tricky things?
- They can cause damage and tissue death by preventing blood flow. That’s what they’re intended to do of course, but it’s not just the wound that no longer gets blood flow.
- They are painful. To actually apply enough pressure to stop blood flow hurts.
- They risk reperfusion injuries and compartment syndrome (and these are bad things we’re not discussing today).
Tourniquets – Your ‘Need to Know’
- Use a dedicated (professional, manufactured) tourniquet whenever possible. If you don’t have one, improvise as best as possible with materials around the scene.
- Apply it one hand-width above the wound and at least two finger-widths away from a joint (you can’t compress a joint space effectively).
- Tighten it until the bleeding stops. You should probably tell them it’s going to hurt. (They may already be telling you this). If you’re using one appropriately, it doesn’t matter as much as the impending risk of death.
- If possible apply the tourniquet to bare skin to reduce the risk of slipping.
- Document the time it was tightened by writing the time on the person’s skin.
- Communicate the use of the tourniquet to EMS or others who take over care. People who have had a tourniquet applied need to be in hospital a.s.a.p.
Get yourself some training; it’s what we do after all.