When Should You Use A Tourniquet

In his novel “The Call Of The Wild,” Jack London describes how an injured dog is suffering from massive hemorrhaging, yet the only person who knows about it is too weak to help him. He doesn’t have enough strength left in his arms to lift the wounded animal into his lap. Instead he wraps his jacket around the pup’s chest as tightly as possible, which stops some blood flow but not all of it. When London releases his grip on the jacket, the dog dies.
That scene may seem far-fetched, but real life isn’t much different. Injured people are often faced with the same dilemma — do they wait until their limbs start to swell before applying direct pressure? Or do they risk losing precious seconds while waiting for paramedics to arrive? And what happens when those first responders need to apply more than just one tourniquet?
Trauma professionals know that bleeding needs to be controlled immediately. If you’re badly injured and bleeding heavily, your body will lose up to 30 percent of its total blood volume within three minutes. That means if you take five minutes to stop the bleeding, you could end up dying during that time due to loss of blood.
If you’ve ever watched a movie where someone was shot or stabbed, then you probably understand why tourniquets play such an important part in modern medicine. They save lives every day. But there are times when tourniquets aren’t always appropriate, and knowing when to use them can make the difference between life and death.
First off, let’s define exactly what a tourniquet does. It constricts the arteries located at the top of your leg (the femoral artery) and at the backside of your thigh (the popliteal artery). This cuts off circulation to these areas, preventing oxygenated blood from reaching them. As a result, tissue begins to die and become gangrenous, causing additional pain and further injury to the area. Without proper treatment, the damage caused by this type of trauma would eventually kill the victim.
So, when should you use a tourniquet? There are several circumstances under which a tourniquet might come in handy. For example, if you’ve been involved in a car accident and suffer a serious head, neck or spinal cord injury, you’ll most likely require a tourniquet to keep you from moving suddenly. Your injuries may also necessitate the use of a tourniquet if medical attention takes longer than expected to reach you.
There are also instances when using a tourniquet won’t work properly. Let’s say you were riding a bike and suffered a minor cut above your ankle. Applying a tourniquet to the injured limb wouldn’t do anything to prevent continued bleeding because the vessels in your foot don’t branch out like other parts of your body. Another scenario would be if you were attacked and had your throat slashed. While a tourniquet might slow down the amount of blood coming from the wound, it wouldn’t completely eliminate the problem.
Before we delve into the reasons why you’d want to use a tourniquet, let’s talk about how they actually work. We mentioned earlier that tourniquets block blood flow by narrowing the main vessel running through the affected area. To accomplish this, specialists typically employ two methods: inflation and deflation. During inflation, pressure is applied to the tourniquet itself, forcing it to squeeze tighter against your skin. Once the desired level of tightness has been achieved, the device stays inflated until it’s removed.
By contrast, deflation involves slowly releasing the pressure exerted on the tourniquet. Again, the goal is to reduce the size of the artery as much as possible without cutting it entirely. To avoid potential complications, however, experts recommend removing the tourniquet once you see no more visible blood leaking from the wound site.
Now that you know how tourniquets work, let’s look at why you might want to use one. Read on for some guidelines on when you should consider deploying one.
Just because you’re wearing long pants doesn’t mean you’re safe from a potentially deadly injury. According to the Centers for Disease Control and Prevention, falls accounted for 40 percent of nonfatal injuries reported to U.S. emergency rooms in 2008. One third of those victims sustained fractures, sprains or dislocations. More than half of those patients needed to go to the hospital.
Circumstances Under Which Tourniquets Might Be Used
Despite the many benefits associated with using a tourniquet, there are situations when you shouldn’t deploy one. First off, you should never use a tourniquet if you notice bone protruding from the surface of the skin. Any sort of pressure placed on bone can cause severe nerve damage or even severing. Also, if you experience extreme pain after having something strapped around your arm or leg, chances are good that you already have sufficient amounts of pressure being applied. Don’t try to add more; simply ask someone to remove whatever item you’re currently wearing.
You should also steer clear of tourniquets when performing surgery. In addition to posing risks related to the patient’s comfort, adding a layer of fabric over the operating table can create a dangerous environment for everyone present. Medical personnel must constantly monitor the area surrounding the surgical site to ensure nothing gets trapped beneath the tourniquet. Furthermore, if the tourniquet becomes dislodged mid procedure, everything underneath it is exposed to the air, increasing the likelihood of contamination.
Another circumstance when you shouldn’t wear a tourniquet is when you’re transporting a patient. While it may seem like a viable option, putting a tourniquet on someone’s torso can pose problems. If you place a tourniquet on a victim’s arm or leg, it can be difficult to get a pulse back up again. Additionally, the increased pressure on the blood vessels near the heart can hinder breathing. Both scenarios can lead to cardiac arrest and death.
Finally, you should avoid using a tourniquet if you’re giving CPR. Not only are you exposing yourself to unnecessary danger, but you could actually be doing more harm than good. By placing a tourniquet on someone’s upper arm, you’re restricting the flow of blood going toward the heart and brain. This reduces the effectiveness of the procedure and increases the possibility of damage to both organs.
For more information on tourniquets, tra­nsquettes and related topics, check out the links below.
According to the American Red Cross, military service members killed in combat receive Purple Hearts for either being wounded or killed. Wounded soldiers receive Silver Stars, while soldiers who died in action are awarded Bronze Stars. Combat medics who saved lives receive Gallantry Awards, and Navy SEALS receive special insignias.

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