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Q:
Did anyone else catch that in the F&S issue for Dec 2012-Jan 2013, under the Bullet Points section, they talked about basic first aid techniques to keep you alive in a pinch. I was just wondering why the use of a tourniquet was not mentioned in the "Killer Cuts" section. I have been taught through my military training on using tourniquets to stop severe bleeding along with positive pressure on the wound. The author did a great job in the short article, I am just curious why he would not suggest a tourniquet coupled with the positive pressure to stop that bleeding. Any ideas?
Question by FlyinMonkey. Uploaded on January 23, 2013
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Answers (11)
touriquets seem to fall in and out of favor every few years it seems, and depending on who you talk to. I believe they are to be used as a last resort if positive pressure and/or occlusive dressings cannot control bleeding.
I was always taught that tourniquets should only be used if the bleeding is severe enough for the victim to die of blood loss. This is due to the belief that a tourniquet if tied eiter improperly or left on for extended periods of time will leave the limb needing to be amputated. The "fear" of the tourniquet caused my Boy Scout troop to not even be taught how to use one.
In first aid now the use of a tourniquet is to be used as a last resort to keep the patient from bleeding to death. It is almost a given that when used the patient will lose the limb it is used on and that is why it is used only as a last resort.
Liability. That's why it was not included in the article, or almost any similar article elsewhere. Use of tourniquets is no longer considered "basic first aid," and using them often results in the loss of a limb, even when done properly. It is considered a last-ditch effort to save a life, and should be used only by those with specific training.
That is my point though, in the article he states that it is arterial bleeding from the femorial artery. I have seen this bleeding, it sprays, the artery retracts into the leg, and most times positive pressure is not going to do the trick. This should be considered basic first aid being that it is so simple and if the bleeding is that bad, the lose of a limb is not the worry, the lose of life is. I have worked with medics that have seen limbs that were tied off with tourniquets for up to 14 hours and sometimes longer and the limbs were not lost. I see where everyone is coming from, I just thought it would be a good topic to talk on and to see what everyones point of view was. Thank you for the comments.
What the others have said is true. I do know that the Boy Scouts of America have quit teaching it due to the fact that if some kid screws up they are liable.
Knife Freak
The above are spot on. It is a very dangerous technique that when used improperly, can cause the loss of a limb, but when used correctly can save a life. I don't consider it to be "basic first aid". I put it in the same class as an emergency tracheotomy. I don't think it should be taught to people with no formal medical training, because they don't have the knowledge and experience to determine when it is necessary, which can lead to more harm than good. People should not be using tourniquets based on some magazine sidebar. They need proper training.
There is also a significant risk of clots traveling to the brain and/or lungs when the tourniquet is released, further risking life, as well as limb.
Great points.
I have been an EMT for 15 years now. The use of a tourniquet is falling back in to favor in the EMS world and Basic First Aid. For years it was thought that a tourniquet would do more harm than good. Many EMS Agencies would lis their use as a LAST Resort intervention. However, recently due to studies done during the war in Iraq and Afghanistan, tourniquets can save a life faster than general direct pressure. Basicly, if someone has a severe enough wound, a tourniquet will stop the bleeding and keep the wounded alive until they can get to defenitive care. Loss of a limb over a life. Many EMS agencies are now listing tourniquets in their protocals as a first line treatment for traumatic injury to a limb. Thank You for your Service to Our Nation FlyinMonkey
Also if you check out the Journal of Emergencie Medical Services or JEMS, I believe they have an article in one of their past issues on tourniquets, and the positive research found.
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In first aid now the use of a tourniquet is to be used as a last resort to keep the patient from bleeding to death. It is almost a given that when used the patient will lose the limb it is used on and that is why it is used only as a last resort.
touriquets seem to fall in and out of favor every few years it seems, and depending on who you talk to. I believe they are to be used as a last resort if positive pressure and/or occlusive dressings cannot control bleeding.
I was always taught that tourniquets should only be used if the bleeding is severe enough for the victim to die of blood loss. This is due to the belief that a tourniquet if tied eiter improperly or left on for extended periods of time will leave the limb needing to be amputated. The "fear" of the tourniquet caused my Boy Scout troop to not even be taught how to use one.
Liability. That's why it was not included in the article, or almost any similar article elsewhere. Use of tourniquets is no longer considered "basic first aid," and using them often results in the loss of a limb, even when done properly. It is considered a last-ditch effort to save a life, and should be used only by those with specific training.
The above are spot on. It is a very dangerous technique that when used improperly, can cause the loss of a limb, but when used correctly can save a life. I don't consider it to be "basic first aid". I put it in the same class as an emergency tracheotomy. I don't think it should be taught to people with no formal medical training, because they don't have the knowledge and experience to determine when it is necessary, which can lead to more harm than good. People should not be using tourniquets based on some magazine sidebar. They need proper training.
There is also a significant risk of clots traveling to the brain and/or lungs when the tourniquet is released, further risking life, as well as limb.
That is my point though, in the article he states that it is arterial bleeding from the femorial artery. I have seen this bleeding, it sprays, the artery retracts into the leg, and most times positive pressure is not going to do the trick. This should be considered basic first aid being that it is so simple and if the bleeding is that bad, the lose of a limb is not the worry, the lose of life is. I have worked with medics that have seen limbs that were tied off with tourniquets for up to 14 hours and sometimes longer and the limbs were not lost. I see where everyone is coming from, I just thought it would be a good topic to talk on and to see what everyones point of view was. Thank you for the comments.
What the others have said is true. I do know that the Boy Scouts of America have quit teaching it due to the fact that if some kid screws up they are liable.
Knife Freak
Great points.
I have been an EMT for 15 years now. The use of a tourniquet is falling back in to favor in the EMS world and Basic First Aid. For years it was thought that a tourniquet would do more harm than good. Many EMS Agencies would lis their use as a LAST Resort intervention. However, recently due to studies done during the war in Iraq and Afghanistan, tourniquets can save a life faster than general direct pressure. Basicly, if someone has a severe enough wound, a tourniquet will stop the bleeding and keep the wounded alive until they can get to defenitive care. Loss of a limb over a life. Many EMS agencies are now listing tourniquets in their protocals as a first line treatment for traumatic injury to a limb. Thank You for your Service to Our Nation FlyinMonkey
Also if you check out the Journal of Emergencie Medical Services or JEMS, I believe they have an article in one of their past issues on tourniquets, and the positive research found.
Post an Answer