Tourniquet and Bleeding Control. Untrained personnel was found to have unacceptably high rates of tourniquet failure when given tourniquets to deploy without any additional training aside from package instructions. A recent randomized controlled trial found that even after tourniquet training, military recruits showed high rates of failure in tourniquet application. However, the Hartford Consensus recommends medical and non-medical personnel to learn how to apply a tourniquet, since it is early and effective placement is known to substantially reduce deaths in the civilian setting. It is estimated that 29% of mortality of civilian prehospital trauma is preventable, 64% of those being due to extremity hemorrhage.
On this page, you will learn more about how to use a tourniquet and remind the anatomy of the upper and lower extremities.
A tourniquet is a type of tight, band-like device that is used to compress a bleeding artery or vein enough so that the flow of blood in the vessels stops completely. Usually, these devices work by compressing the soft vessels against the patient's hard bone.
There are many types of ready-made tourniquets available, but you can make your own device using fabric and a rigid stick or pole to adequately compress the vessels.
- A tourniquet can be used when you have profuse arterial bleeding that you can not control with pressure or packing, or when you have multiple sites of bleeding that are too many to pack individually.
- Studies show that the tourniquet pressure has to be approximately 100mmHg over the systolic blood pressure.
- A tourniquet is ideally placed 2-3 inches above the wound or locations of bleeding.
Our simulator will show you how to correctly apply tourniquets to stop bleeding.
Adequate Use of the Tourniquet[edit | edit source]
How to Apply the Tourniquet[edit | edit source]
References[edit | edit source]
- Dennis A, Bajani F, Schlanser V, Tatebe LC, Impens A, Ivkovic K, Li A, Pickett T, Butler C, Kaminsky M, Messer T, Starr F, Mis J, Bokhari F. Missing expectations: Windlass tourniquet use without formal training yields poor results. J Trauma Acute Care Surg. 2019 Nov;87(5):1096-1103. doi: 10.1097/TA.0000000000002431. PMID: 31274827.
- Tsur AM, Binyamin Y, Koren L, Ohayon S, Thompson P, Glassberg E. High Tourniquet Failure Rates Among Non-Medical Personnel Do Not Improve with Tourniquet Training, Including Combat Stress Inoculation: A Randomized Controlled Trial. Prehosp Disaster Med. 2019 Jun;34(3):282-287. doi: 10.1017/S1049023X19004266. Epub 2019 May 2. PMID: 31043185.
- Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, Wade CE, Salinas J, Holcomb JB. Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg. 2009 Jan;249(1):1-7. doi: 10.1097/SLA.0b013e31818842ba. PMID: 19106667.
- Kragh JF Jr, O'Neill ML, Walters TJ, Dubick MA, Baer DG, Wade CE, Holcomb JB, Blackbourne LH. The military emergency tourniquet program's lessons learned with devices and designs. Mil Med. 2011 Oct;176(10):1144-52. doi: 10.7205/milmed-d-11-00114. PMID: 22128650.
- Davis JS, Satahoo SS, Butler FK, Dermer H, Naranjo D, Julien K, Van Haren RM, Namias N, Blackbourne LH, Schulman CI. An analysis of prehospital deaths: Who can we save? J Trauma Acute Care Surg. 2014 Aug;77(2):213-8. doi: 10.1097/TA.0000000000000292. PMID: 25058244.
- Tejwani NC, Immerman I, Achan P, Egol KA, McLaurin T. Tourniquet cuff pressure: The gulf between science and practice. J Trauma. 2006 Dec;61(6):1415-8. doi: 10.1097/01.ta.0000226159.84194.34. PMID: 16983305.