Tourniquets only work on limb injuries, not trauma to the head or torso. Injuries to the head and torso require applied pressure with some absorptive material in order to slow or stop bleeding, not a tourniquet. A severely injured person may also require basic life-saving measures, such as CPR (clearing airways, mouth-to-mouth resuscitation, chest compressions) and shock prevention. The term “tourniquet” originated in the late 1600s from the French word “tourner,” which means to turn or tighten. [3] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
If left uncontrolled, bleeding will eventually lead to shock, then death. If at all possible, use latex or similar types of gloves while in contact with the blood of another person as it will help stop the transmission of certain diseases. Even if you have to use a tourniquet, leave the make-shift bandage on the wound because it will help promote clotting when the blood flow slows down. Elevate the wound if possible. Often the combination of pressure and reducing the pull of gravity on the flow of blood in the vessels will be enough to stop the bleeding and allow clot formation.
Try to make a quick 911 emergency phone call (or ask a bystander) as soon as you are able. In most severe injuries, the use of a bandage and/or tourniquet is merely buying time so that trained medical personnel can take over and do what’s necessary. Make the injured person as comfortable as possible while you’re giving them help. Put something padded underneath their head.
Good choices would be a necktie, bandana, leather belt, straps from knapsack or handbag, cotton shirt or long stocking. To minimize cutting into the skin, ensure that the improvised tourniquet is at least an inch wide and preferable two to three inches in width. If the tourniquet is for a finger, a somewhat smaller width is fine, but avoid string, twine, dental floss, wire, etc. In an emergency situation with lots of blood, you need to resign yourself to the fact that you’ll be getting blood on your clothes, so don’t hesitate to use an article of clothing for a tourniquet.
For wounds that are just below a joint (such as the elbow or knee), place your tourniquet just above and as close to the joint as you can. Your tourniquet should have some padding underneath it to prevent skin damage, so use the victim’s clothing (pant leg or shirt sleeve) to place under it if you can. If your tourniquet is long enough, wrap it around the injured limb numerous times, keeping it as flat as possible. You want the tourniquet to stop blood flow in the arteries, but not cut into and damage any soft tissues while doing so.
First, tie a half-knot with the tourniquet, then place the rigid object on top before tying a full knot over it. You can then twist the elongated object until the tourniquet is tight around the injured limb and the bleeding stops. Small tree branches, a screwdriver or wrench, thin flashlights, or thick marker pens all work well as torsion devices for tourniquets.
If necrosis sets in, then leg amputation is very likely. As a general guideline, two hours is considered the length of time a tourniquet can be tied before neuromuscular injury begins (loss of normal function) and perhaps three to four hours before necrosis becomes a serious concern. However, in an emergency situation with no medical help close by, you may have to make the choice of sacrificing a limb to save a life. [10] X Research source If you think medical help will take longer than two hours to arrive, then cool the limb down with ice or cold water (while elevated) if you can — it may help delay tissue injury and loss of function. Mark the victim’s forehead with a “T” to indicate a tourniquet has been applied, and also note the time when it was applied so medical personnel know.
If you don’t have any latex gloves to wear, look around or ask any bystanders for some hand sanitizer before you touch the wound. If you have sterile saline available, this is the best for cleaning wounds. Otherwise, alcohol, vinegar, natural honey, hydrogen peroxide, and bleach are all good antiseptics that may be available for you to use on your hands or the victim’s injury before you dress it.
There may not be much you can do to prevent shock, but you can tell the medical personnel your observations when they arrive. The greater and more rapid the loss of blood, the more severe the shock symptoms. Post-tourniquet syndrome typically lasts from one to six weeks and includes weakness, numbness, pallor, and stiffness in the injured limb. [13] X Research source
