Tourniquet

A device used to apply pressure to a limb or extremity to limit blood flow

A tourniquet is a device that applies pressure to a limb or extremity in order to limit – but not stop – the flow of blood. It can be used in emergencies, in surgery, or in post-operative rehabilitation. Tourniquets are widely used in both medical and military settings.

History

The use of tourniquets dates back to ancient times. The earliest recorded use was by the Romans, who used them to control bleeding during amputations. In the 18th century, the French surgeon Jean-Louis Petit developed the screw tourniquet, which allowed for more controlled application of pressure.

Types of Tourniquets

Tourniquets can be broadly classified into two types: emergency tourniquets and surgical tourniquets.

Emergency Tourniquets

Emergency tourniquets are used in situations where there is severe bleeding from a limb, such as in traumatic injuries. They are designed to be applied quickly and effectively to control hemorrhage until further medical treatment can be administered. Common types include:

• Combat Application Tourniquet (CAT): Used by military personnel, it is a one-handed tourniquet that can be applied quickly in the field.
• SOF Tactical Tourniquet (SOFTT): Another military-grade tourniquet, known for its durability and ease of use.

Surgical Tourniquets

Surgical tourniquets are used in operating rooms to create a bloodless field for surgery. They are typically pneumatic devices that can be precisely controlled to apply the desired amount of pressure. These tourniquets are used in procedures such as knee arthroscopy and limb surgeries.

Mechanism of Action

A tourniquet works by applying circumferential pressure to a limb, compressing the underlying tissues and occluding blood vessels. This stops the flow of blood to the distal part of the limb, which can be crucial in preventing exsanguination in cases of severe trauma.

Application Technique

The proper application of a tourniquet is critical to its effectiveness. The general steps include:

1. Placement: The tourniquet should be placed 2-3 inches above the wound, avoiding joints. 2. Tightening: The tourniquet should be tightened until the bleeding stops. This may require significant force. 3. Securing: Once tightened, the tourniquet must be secured to prevent it from loosening. 4. Time Recording: The time of application should be noted, as prolonged use can lead to tissue damage.

Risks and Complications

While tourniquets are life-saving devices, they can also cause complications if used improperly. Potential risks include:

• Nerve Damage: Prolonged pressure can damage nerves, leading to numbness or paralysis.
• Tissue Necrosis: Extended use can lead to tissue death due to lack of blood supply.
• Compartment Syndrome: Improper application can cause increased pressure within a muscle compartment, leading to further complications.

Images

A tourniquet being applied to a limb.

File:Combat Application Tourniquet.jpg

A Combat Application Tourniquet (CAT) used in military settings.

Related Pages

• Hemorrhage
• First aid
• Trauma surgery
• Emergency medicine