Tourniquets’ are lifesaving tools used to stop life-threatening bleeding from the arms or legs when direct manual pressure alone is ineffective.
They are used regularly in emergency situations by first responders and medics on battlefields across the globe.
The concept of using pressure to control bleeding is not new. As early as 600 BC, the renowned Indian physician Sushruta, who some refer to as the ‘father of surgery’, described the use of ligatures and tourniquet-like tools in his medical text.
These primitive instruments would have been a far cry from the devices we see in the field today. It wasn’t until the early 18th century when a French surgeon by the name of Jean Louis Petit developed a screw device for effectively tightening a tourniquet.
In the modern era, tourniquets have become so advanced that on some battlefields, for fast application, they are being stitched into soldiers clothing.
In fact, they have been used so regularly in recent warzones, it is thought that between 2005 and 2011, tourniquets saved 2,000 American lives in Iraq and Afghanistan.
There has been much talk about the effectiveness of Tourniquet’s being used by first aiders. The official guidance (like that of the NHS) takes the conservative stance of only using Tourniquet’s as a last resort, however with the proliferation of Public Access Bleed Control Kits (and within them Tourniquet’s) it is worth exploring whether they have a role to play within First Aid.
The decision on when or when not to use a tourniquet can be a difficult one to an untrained member of the public. It’s therefore important to understand when they can be really affective or when it is better to consider a different technique to stop the bleed. For example, they can only be used on limbs and can’t be placed or tightened over a joint.
Many of the general public may have the view that tourniquets are easy to apply. Action movies and TV shows have shown us that simply tying a belt or tie around the damaged limb will be sufficient to save a life.
However, the reality of this is quite different. The first hurdle to overcome when using a tourniquet is ensuring it is tight enough to completely stop the blood flow in both the veins and arteries.
If a tourniquet is not sufficiently tightened, it will compress the veins, but not the arteries, which could make the condition worse. Simply tying a tourniquet over a limb won’t ordinarily provide adequate pressure, the key to successful application lies in the twisting device, known as a windlass.
This too can be improvised, a screwdriver, small broom handle or even a pair of sturdy chopsticks can be used to tighten a tie, tights, belt or triangular bandage in emergency situations.
Learn how to tie a tourniquet
here One of the main concerns around using a tourniquet is the fear that it might cause more harm to the limb than the bleeding itself. However, current evidence suggests that a tourniquet can remain in place for up to two hours before there is a significant risk of permanent tissue damage. In fact, serious complications such as long-term damage or amputation typically do not occur unless the tourniquet is left in place for four to six hours.
In summary, tourniquets are an invaluable tool in the treatment of catastrophic limb bleeding. However, their effectiveness will depend entirely on correct application and appropriate use.
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