First Aid - Snakebite & Tourniquet 101 Part 1
Monte Kalisch (montek@MONTEKCS.COM)
Thu, 26 Dec 1996 23:37:05 -0700
At 01:06 AM 12/17/96 +0800, you wrote:
>I probably should have qualified my statement about tourniquets. What we
>were taught was that this is the only situation in which there may still be
>an appropriate use for them, but not that they are routinely used for
>amputations. Basically only if there is such severe damage that there is no
>real likelihood of reconnecting and bleeding cannot be stopped any other
>way. Even then, the "tourniquet" is not the old bootlace type of thing, but
>a bandage tied firmly enough to cut off blood flow, and released and
>reapplied if necessary every 30 minutes to minimise tissue damage at the
>point of application.
Tourniquet use is a very specialized first aid measure and its misuse is
very common. There is only one acceptable method of tourniquet use (please
note the distinct different between tourniquets and constriction bands [see
previous post on this same topic]). The only acceptable use of tourniquets
is in massive blood loss situations where other methods of controlling
blood loss have failed. The other methods are direct pressure, elevation,
and pressure points. In fact, I have only known one paramedic in one
situation that said these actions didn't work. I *only* use these methods
to control massive blood loss (they work!).
The other key misconception about tourniquets is the 30-minute release to
"minimize" tissue damage. This is a big NO-NO. Once a [real] tourniquet
has been applied, it is NEVER to be removed in the field. The reasoning is
very simple, actually. Since you only use a tourniquet when things have
gotten "that bad," it must be a life or limb situation and you've chosen
the life (good choice). Once the decision has been made, make the
tourniquet so tight that no blood goes to or from the point beyond the
tourniquet. Releasing the tourniquet (in the field) at any time can kill
the patient by causing tourniquet shock. Like all forms of shock,
tourniquet shock is quick and fatal. Just think about what happens to
blood that doesn't move around (it gets yucky and stiff); if you release
that icky blood back to the heart, it will pump it all over the body. That
blood can contain poisons, etc. that will kill the patient if you do such a
thing.
>It is really a "last resort" first aid method. The preferred treatment if
>possible is a firm wound dressing over the stump to stop bleeding, pack=
the
>severed body part in ice, and get to a hospital as soon as possible.
You're right: tourniquet use is a "last resort." Remember that it's a
life or limb situation that you should NEVER have to make if you rely on
your other first aid measures.
Yours in Scouting,
Monte Kalisch
Nationally Registered Emergency Medical Technician
CPR Instructor
Monte Kalisch =95 mailto:montek@montekcs.com
http://www.montekcs.com/www/personal
I watched the Indy 500, and I was thinking that if they left earlier they
wouldn't have to go so fast. =97Steven Wright=20
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