In this episode of the Rebel Core Content podcast, Swami provides crucial tips on using tourniquets. Highlighting the significance of these life and limb-saving devices, the discussion focuses on the optimal placement of tourniquets, emphasizing placing them 2-3 inches (5-6 cm) above the bleeding source and avoiding joints. Swami also advises on the correct way to tighten the tourniquet using the Velcro strap first, followed by minimal use of the windless. The importance of noting the application time to avoid prolonged arterial flow interruption is also discussed. The episode concludes with a reminder to visit the podcast’s website for more valuable content.
The post REBEL Core Cast 144.0: Tourniquet Tips appeared first on REBEL EM – Emergency Medicine Blog.
The medical content discusses proper tourniquet use for life threatening extremity bleeding. Tourniquets are indicated when direct pressure fails, in mass casualty situations, or when the scene is unsafe. Commercial tourniquets such as CAT, SOFTT-W, and SAM XT are preferred. Makeshift tourniquets, if necessary, should be at least 1.5 inches wide and include a windlass.
Application involves placing the tourniquet high and tight on the limb, proximal to the injury and preferably on bare skin, avoiding joints. It should be tightened until bleeding stops and distal pulses are absent, then the windlass must be secured. The time of application must be noted.
Tourniquets are generally safe. Limb loss from tourniquet use is rare if applied for less than two to three hours. The greater risk is uncontrolled blood loss. Pain is an expected sign of proper application and should not be a reason to loosen the tourniquet. Typical pressures are 300 mmHg for upper extremities and 400-500 mmHg for lower extremities. Tourniquets should not be removed in the prehospital setting.
If bleeding persists after one tourniquet, a second one can be applied proximally. Tourniquets are safe for children and effective for traumatic amputations. Avoid placement over bulky items like pockets, as this can prevent proper compression. Pain management can be considered once bleeding is controlled.
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