2010-01-22 - Tie a tourniquet

Tourniquets are definitely a last resort method of stopping bleeding. Depending on the type of wound you would typically apply direct pressure to it to stop the bleeding. You can also try elevating the wound to reduce bleeding. A tourniquet is an extreme measure to be taken only when absolutely necessary. If done incorrectly or unnecessarily it can do more harm than good.

A tourniquet is a device used to stop the flow of blood to a part of the body. It's used when there is extreme blood loss from an extremity and the person is in risk of bleeding out. It's usually a fabric or belt of some kind that can be tightened around the limb to cut off circulation.

When to use:
Only when absolutely necessary. If you think the person is at serious risk of dying from blood loss and you cannot get the bleeding to stop by any other means. Obviously if someone is really bleeding that much you should first call someone who knows what they're doing.

What to use:
Any non-stretchy fabric or other material with which you can tie a knot. To get the necessary pressure for some applications you will need a windlass, basically a crank to get more pressure than simply tying a knot.
You want a narrow, strong strip of fabric about an inch wide if possible. Anything larger you'll never get enough concentrated pressure to stop the bleeding and anything narrower you can start doing tissue damage and act more like a garotte wire. You can improvise a handle for the windlass out of a piece of pipe or broomstick or something comparable - as long as it's strong enough that it won't break while winding the tourniquet.

How to use:
Locate the wound. It should be pretty obvious if it's bleeding enough to require a tourniquet. You're going to apply the tourniquet "upstream" from the wound. You're trying to block off the flow of blood away from the body so you need to get between your heart and the wound. The points on this diagram are also where you should first attempt to apply pressure to stop the bleeding.

Tie one knot around the limb. Make a second knot above that to insert the handle of the windlass. You'll definitely need a windlass for the leg because of the pressure coming out of the arteries down there. Remember- you're fighting a lot of pressure. The blood is circulated with an insane amount of force so it's going to have to be pretty tight to stop that circulation.

You'll know when it's tight enough because the bleeding will stop. It should be pretty obvious- like turning off a faucet. Once tight enough- secure the windlass in position so it doesn't loosen. Tie the end of the handle to the limb it's tying off.

Again- only use if completely necessary. It can save someones life- but it can also do a lot of damage. Any time you stop circulation to an extremity for an extended period of time it will start to damage the tissue. If not tight enough it will only apply pressure which can increase bleeding. If removed incorrectly it can cause a large amount of blood loss in a small amount of time (think: putting a kink in a hose and then letting it go) which can send the person into shock. Never remove a tourniquet- leave it for a professional.


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