Recently we discussed the importance of IFAK pouches, their contents, and why you should consider one. Today we are talking purely about tourniquets. Tourniquets are a shockingly simple, yet life saving tool designed to stop arterial and other severe bleeding. Imagine you come upon a severe car accident while traveling a rural road, hiking in the wilderness, or present during a natural disaster where rendering immediate aid to a severe bleed is the difference between life and death. An untreated wound to a major artery can cause someone to bleed out anywhere between 2 minutes to hours depending on the degree to which it was severed.
So, What Exactly is a Tourniquet?
A tourniquet is a constricting device used to control or stop the flow of blood through an artery by applying pressure with a band around the extremity. By doing so, it can save lives by preventing excessive blood loss from a severe injury. Basically, stopping the bleeding by stopping the blood from reaching the open area.
The use of tourniquets dates back hundreds, if not thousands of years. The concept of applying pressure to stop bleeding is even mentioned in writings from ancient Greece. The term “tourniquet” itself comes from the French “tourner,” which means “to turn,” a reference to the original tourniquets that were tightened by twisting a stick in a loop of cloth placed above the wound, a design that would ultimately lead to the CAT tourniquets of today.
The tourniquets we’re familiar with today, made of sturdy materials with a windlass for tightening, were developed in the late 17th century by French surgeon Jean-Louis Petit. These devices could be applied quickly and easily, making them invaluable on the battlefield and in emergencies.
Despite their life-saving capabilities, tourniquets fell out of favor in the medical community during the 19th century due to concerns about complications, including nerve damage and potential loss of the limb. The pendulum has swung back in recent years, with modern combat experiences in Iraq and Afghanistan demonstrating that tourniquets, when used properly save lives in traumatic injury situations with severe bleeding, and cause little to no permanent damage.
Today, tourniquets are considered essential components of first aid kits, especially IFAKs and tactical medical gear. Their potential to stop life threatening bleeding makes them an indispensable tool in any emergency situation. Nevertheless, it’s crucial that individuals are trained to use them correctly to minimize the risk of complications.
Modern tourniquets have come a long way from the simple bands of fabric used in the past. Today, they are typically made from strong, durable materials and feature a windlass system—a rod or bar that can be twisted to tighten the tourniquet and effectively stop the blood flow. Some advanced versions even have a ratchet system for precise control of pressure. One popular example is the Combat Application Tourniquet (C-A-T), widely used by military and emergency medical services worldwide.
Modern tourniquets are designed to be easy to use, even under high stress, with many models enabling one handed operation. They also include a space to mark the time of application—a crucial piece of information for medical personnel, as tourniquets should not be left on for extended periods due to the risk of damage to the affected limb.
Why Might You Need a Tourniquet?
A tourniquet is an essential piece of equipment in any first aid kit, especially in tactical first aid kits.
Severe Trauma
Accidents that cause deep lacerations or amputations can result in heavy bleeding that can’t be controlled with direct pressure alone.
Outdoor Activities
If you’re involved in outdoor activities like hiking, camping, or hunting, having a tourniquet on hand is important. You never know when an accident might occur, such as a fall leading to a deep cut or a wild animal attack.
Dangerous Jobs
People working in dangerous environments, such as military, law enforcement, construction, and logging, etc. may be at risk of severe injuries that can cause heavy bleeding.
Mass Casualty Incidents
In cases of mass shootings, bombings, or other mass casualty incidents, tourniquets can be used to control bleeding and save lives before emergency personnel can reach the scene.
Preparedness
Even in everyday life, accidents can happen. A car accident, a kitchen mishap, or an unexpected disaster can lead to severe injuries. Having a tourniquet and knowing how to use it could mean the difference between life and death.
In any situation where severe bleeding occurs, a tourniquet can be a lifesaving tool. Tourniquets are extremely simple to use, so while proper training is important, anyone with a basic understanding of how tourniquets work via instructional videos, or practice will be able to effectively apply one.
How To Use a Tourniquet in 6 Steps
Using a tourniquet properly can save a life in an emergency. Here’s a basic guide on how to use a modern tourniquet like the Combat Application Tourniquet (C-A-T)
~I am not a doctor, or certified trainer, and this is not medical advice~
Step 1 – Identify the Injury: First, determine if a tourniquet is necessary. Tourniquets are used for severe bleeding that can’t be controlled by direct pressure or pressure bandages, or if the limb is partially or completely amputated. If blood is ‘spurting’ then use a tourniquet. Arterial bleeds lead to blood gushing, or spurting, and are the most dangerous because this means massive blood loss.
Step 2 – Placement of the Tourniquet: Place the tourniquet above the wound, but never on a joint (like the knee or elbow). If the wound is on a joint, place the tourniquet above the joint. A rule of thumb is place the tourniquet as high as possible on the affected limb.
Step 3 – Secure the Tourniquet: For a CAT tourniquet, loop the band around the limb and pass the free end through the inside of the buckle, forming a loop around the limb. Pull the band tight and securely fasten it back on itself, attaching it with the Velcro.
Step 4 – Tighten the Tourniquet: Twist the windlass (the rod or stick on the tourniquet) until the bleeding stops. This might require a lot of force. The tourniquet should be tight enough to stop arterial blood flow, not just venous (vein) flow, which means it will hurt.
Step 5 – Secure the Windlass: Once the bleeding has stopped, lock the windlass in place. Most tourniquets have a clip or holder designed for this.
Step 6 – Note the Time: Write down the time the tourniquet was applied. This is really important for paramedics and doctors to know.
Step 7 – Seek Medical Help: After applying a tourniquet, seek immediate professional medical help. A tourniquet is a temporary measure and should only be removed by a medical professional.
Remember, improper use of a tourniquet can cause harm, so it’s essential to have appropriate training. This guide is a basic overview and does not replace formal training and certification.
Always ensure you regularly check and maintain your tourniquet to ensure it’s in working order. This is something we put a lot of emphasis on for all of your equipment.
Frequently Asked Questions
What is a tourniquet?
A tourniquet is a device that is used to stop severe bleeding in an emergency situation. It is typically a tight band that is applied around a limb above an injury to slow the blood flow, tightened with a windlass until bleeding stops.
When should a tourniquet be used?
A tourniquet should be used when there is severe bleeding that cannot be controlled by direct pressure. It is often used in situations involving severe trauma, such as car accidents, industrial accidents, or gunshot wounds where an artery is damaged.
How do I apply a tourniquet?
Place the tourniquet 2-3 inches above the bleeding site (never on a joint) and tighten it until the bleeding stops. If the bleeding does not stop the tourniquet is too low or too lose and a second one needs to be applied before removing the first.
Is it true that once a tourniquet is applied, the limb will need to be amputated?
Absolutely, unequivocally no. This is an old myth. While tourniquets can cause tissue damage if left on for extended periods, they are a lifesaving tool when used properly. The risk of a tourniquet causing the need for amputation is far less than the risk of a person bleeding to death.
This myth likely originated from combat like the Civil War where treatment was often worse than the wound itself.
How long can a tourniquet be left on?
It is generally recommended that a tourniquet not be left on for more than two hours. However, in some cases, a tourniquet can be left on for longer if necessary. Medical professionals can take measures to reduce the risk of complications.
What should I do after applying a tourniquet?
After applying a tourniquet, the next step is to seek immediate medical attention. Record the time the tourniquet was applied as this can be helpful information for the medical team.
Can I use an improvised tourniquet?
Only if you absolutely have to. Modern tourniquets are very affordable and will be much more effective. A belt can be used if necessary, but it is difficult to control the proper pressure, and complications are much more likely to arise using an improvised tourniquet.
Are there any risks or complications associated with tourniquet use?
Potential risks and complications of tourniquet use can include nerve damage, tissue death, and blood clot formation. However, the benefits of stopping severe bleeding far outweigh these risks. These complications are rare with modern tourniquets, and generally occur if applied improperly or left in place for hours on end.
Who can apply a tourniquet?
Ideally a trained professional will apply a tourniquet. However, in an emergency anyone can apply one. It’s important to get training on the correct way to use a tourniquet if possible, but familiarize yourself with how to use one will make a big difference.
Are all tourniquets the same?
No, there are different types of tourniquets including pneumatic (inflatable) tourniquets used in surgical settings, and non-inflatable or mechanical ones often used in pre-hospital or battlefield environments. The latter category includes windlass tourniquets, such as the Combat Application Tourniquet (CAT), which are often preferred due to their simplicity and effectiveness.
Why are tourniquets used?
Tourniquets are used to control bleeding during surgery on the extremities and in emergency situations to prevent excessive blood loss from a severe injury.
Where should a tourniquet be placed?
A tourniquet should be placed around the limb, above the bleeding site. If possible, it should be placed 2-3 inches above the wound, but never on a joint.
How tight should a tourniquet be?
A tourniquet should be tightened until the bleeding stops.
Can a tourniquet be harmful?
If not used properly, a tourniquet can be harmful. Misuse can cause damage to nerves, blood vessels, and muscles. Furthermore, if left on for too long, it can lead to the loss of the limb.
Is it okay to loosen or remove a tourniquet once applied?
Once applied, a tourniquet should not be loosened or removed unless it is done by a medical professional. Removing a tourniquet can lead to a sudden rush of blood carrying toxins from the damaged tissue back into the body’s system, which can be dangerous. Further, this sudden rush of blood will remove in clotting that has helped stop the bleed. If the tourniquet must be removed, due to damage then a new one should be applied prior to removal.
Can tourniquets be reused?
Most commercial tourniquets are designed for single-use only to prevent cross-contamination between patients, and the elastic being stretched during tightening. However, in extreme circumstances or for training purposes, some may be reused after appropriate cleaning.
Final thoughts
Tourniquets are a critical tool in lifesaving first aid, particularly when dealing with severe bleeding that can’t be controlled by other means. While the device has evolved significantly over the centuries, the fundamental principle remains to stop blood flow from a severe wound.
Modern tourniquets like the Combat Application Tourniquet (C-A-T) are designed to be quickly and effectively applied, even in high-stress situations. However, it’s essential to remember that proper training is important for the safe and effective use of these devices. Familiarization with the principles will allow you to effective apply a tourniquet in a life and death situation.
It’s also vital to understand that while tourniquets can save lives, they are a temporary measure. Anyone applying a tourniquet should seek immediate professional medical help. The tourniquet should not be removed until under the care of medical professionals, who need to know the time the tourniquet was applied.
In conclusion, tourniquets are an indispensable tool in emergency medical care. When used correctly, they can make the difference between life and death in situations of severe bleeding. Therefore, knowing what a tourniquet is, why you might need one, and how to use it correctly, is knowledge that could prove invaluable one day. Need to keep a tourniquet on your gear? No problem, we have you covered with soft and hard tourniquet holders for belts, plate carriers, and other medical supplies.
The opinions expressed in this post are those of the author and do not necessarily reflect the views and opinions of Tacticon Armament.
