Tourniquets are very tight bands that are applied to injured limbs with the purpose of controlling or stopping blood loss in emergency situations. They can be used on both people and animals and can save lives when it is difficult to get medical intervention in the right time. They are not a long-term solution to a serious injury, but are effective in controlling bleeding in the short term, until the wound is treated by a professional rescuer. It is important to learn how to use this accessory correctly, because a wrong technique (or too long application times) can actually generate complications, such as necrosis and amputation.
Steps
Part 1 of 3: Assess the Injury
Step 1. Try to locate the site of the bleeding
If you find yourself in an emergency situation where an individual or animal is seriously injured, approach the victim with a firm and reassuring attitude. Helping someone who is in danger of life is certainly a courageous gesture, but you must try to discover and assess the injury as quickly as possible. Have the victim lie down and look for the spot where the blood is coming out. Tourniquets can only be applied to the limbs and cannot be used for head or torso trauma. In the latter two cases it is necessary to apply pressure on the wound with absorbent material (and not use the tourniquet) to slow or stop the bleeding.
- A seriously injured person may need basic life-saving procedures, such as cardiopulmonary resuscitation (clearing the airways and "mouth-to-mouth" breathing) and shock prevention.
- Remember that in some countries the use of the tourniquet by people who are not part of the medical staff or who are not professional rescuers is a crime and could lead to a civil or criminal case.
Step 2. Apply pressure to the wound
Most injuries that lead to external bleeding can be controlled with direct pressure. For this reason, grab something absorbent and possibly clean, such as sterile gauze (even if sometimes all you have is your shirt), to place over the wound and press firmly. Your goal is to close the wound and promote clot formation, as this cannot happen as long as the blood is flowing freely. Gauze pads (or other absorbent material such as sponge or cotton) are great for preventing blood from leaking out of the wound. If the gauze, cloth, or item of clothing you used becomes soaked in blood, add another layer of fabric without removing the first. Removing blood-filled tissue from the wound will quickly remove any clotting factors that have formed and may encourage bleeding. However, if the injury is too severe and you can't stop the bleeding with pressure, then you should consider using the tourniquet in this case (and only this one).
- If left untreated, the bleeding can lead the victim into a state of shock and eventually death.
- If possible, use latex gloves or something similar to touch another person's blood to prevent transmission of certain diseases.
- Leave the improvised bandage or gauze on the wound, even if you have to apply a tourniquet, because its presence promotes clotting when blood flow slows.
- Lift the injured area if possible. The combination of pressure and elevation is often able to reduce the action of gravity on the blood flow within the vessels until the bleeding stops and allows a clot.
Step 3. Try to calm the victim down
Panic is harmful in any emergency situation, so try to calm the injured person using a reassuring tone. Prevent him from seeing the wound and bleeding if you can, as many individuals are shocked at the sight of the blood and immediately imagine the most catastrophic scenario. You should inform the victim of your actions, such as when applying a bandage and / or tourniquet. It is very important to let her know that help is on the way.
- Make a quick call to 911 or ask someone nearby to do so as soon as possible. In severe cases, the use of a bandage and / or tourniquet is only a means of gaining time while waiting for medical personnel to arrive and do whatever is necessary.
- Try to make the wait as comfortable as possible for the victim by giving them all the help you can get. Put something stuffed under her head.
Part 2 of 3: Apply the tourniquet
Step 1. Choose the most suitable material
If you have a proper tourniquet at your disposal, this is undoubtedly the best solution; however, in emergency situations it is often necessary to improvise. In the absence of a medical tourniquet, you need to choose a strong, moldable (not too stretchy) object that is long enough to tie around the injured limb. Best options include a tie, bandana, leather belt, backpack or purse straps, cotton shirt, and long socks.
- To avoid damaging the victim's skin, make sure that the makeshift lace is at least 2.5 cm wide, preferably 5 or 8 cm. However, if the tourniquet is to be applied to the finger, a thinner object is fine, but avoid twine, floss, wire, and other similar items.
- In emergencies, when there is abundant blood loss, you will have to resign yourself to the idea that you will get bloodied, so don't hesitate to use a piece of clothing as an improvised lace.
Step 2. Apply the tourniquet between the heart and the wound
Wrap it around the injured limb upstream of the injury or near it. The goal is to stop the powerful blood flow from the arteries and not what goes back to the heart through the superficial veins. To be more precise, you should put the tourniquet about 2.5-5 cm from the wound flap and not directly on it, otherwise the arteries upstream of the injury will continue to pour blood into it, which will eventually exit the body..
- If the wound is just below a joint (such as the knee or elbow), wrap the tourniquet just above it, as close to the joint as possible.
- The tourniquet should be equipped with some sort of padding to avoid damaging the victim's skin, for this purpose you can use the clothes of the same injured person (the trouser leg or a sleeve of the shirt) and place them under the lace, if possible.
- If the lace is long enough, wrap it several times around the limb trying to keep it as flat as possible. Your goal is to stop arterial blood flow without damaging the soft tissue surrounding the wound.
Step 3. Use a stick or rod to tighten the lace
A normal knot that closes the makeshift tourniquet is not enough to control the bleeding, even if the fabric has been wrapped tightly several times. This is especially true if the material expands when it gets wet. For this reason you must use a stick or a wooden or plastic rod (at least 15 cm long) as a tool to twist the lace. First, close the lace with a simple knot, then place the rigid object on top of it before closing everything with a second knot. At this point, you can rotate the cane until the lace is tightly tightened around the injured limb and the blood stops.
Small tree branches, a screwdriver or wrench, even a thin flashlight or thick pen are perfect as tourniquet twisting devices
Part 3 of 3: Minimize Complications
Step 1. Don't leave the lace on for too long
This device is to be used only as a short-term remedy; in reality there are no researches that clearly indicate the time limit after which the absence of blood triggers tissue necrosis, since each individual is slightly different from a physiological point of view. If necrosis begins, limb amputation becomes a very likely risk. It is generally believed that it takes two hours of tourniquet application before neuromuscular damage (loss of normal tissue function) sets in and that it takes three to four hours for necrosis to become a real concern. However, in an emergency situation with no medical support available, it may be necessary to sacrifice a limb to save a life.
- If you feel that help cannot arrive for two hours and if you are able, cool the limb with ice or cold water (while it is raised) to slow tissue damage and loss of function.
- Trace the letter "L" on the victim's forehead to indicate that you have applied the lace and do not forget to check the time you put it on, so as to communicate the information to the rescuers.
Step 2. Try to keep the wound clean as much as possible
In theory, the tourniquet should stop or slow down arterial bleeding considerably, but you must do your best to protect the wound from any debris, as all tears are at risk of infection. Before applying a compression dressing, it is worth rinsing the wound with clean water, as you will not be able to remove the gauze once it is placed on it. In any case, you can prevent the affected area from getting dirty by placing an improvised bandage and covering it with a blanket or piece of clothing.
- If you don't have latex gloves to wear, shop around for a hand sanitizer or ask someone nearby to give you hand sanitizer before touching the wound.
- If you have sterile saline solution available, know that this is the ideal liquid to wash the wound. If not, remember that alcohol, vinegar, raw honey, hydrogen peroxide, and bleach are all great antiseptics for cleaning your hands or wound before bandaging.
Step 3. Make sure the victim is warm and well hydrated
If medical help is delayed for any reason, then the injured person may have chills and intense thirst both of which are caused by the severe blood loss. The severity of these symptoms also depends on the environmental conditions and the amount of blood lost. It is therefore necessary to obtain a blanket or other clothing to keep the individual warm and give him water or juice to drink. Chills can also be a sign of hypovolemic shock which also causes faster breathing, confusion, anxiety, clammy and bluish skin, and loss of consciousness. There isn't much you can do to prevent shock, but you can report your observations to medical personnel once you arrive.
- The severity of shock symptoms is directly proportional to the amount of blood lost and the rate of bleeding.
- After using the tourniquet, the victim may experience some limb changes that could last from one to six weeks and include weakness, numbness, paleness and stiffness in the injured limb.
Advice
- Do not cover the tourniquet once applied. It must be in plain sight so that the medical staff, upon arrival, notice its presence.
- Using a tourniquet to stop bleeding before engaging in cardiopulmonary resuscitation helps to conserve the victim's blood volume.
- Once the tourniquet is tightened, you do not have to loosen it, otherwise it could trigger even more bleeding that could prove fatal.
