Using a tourniquet

[MazDan]

I was watching a real life drama show on tele tonight where an emergency line operator was contacted by a young girl whose Mum had accidentily sliced her wrists on a window and was losing large quantities of blood.

The girls had placed towels around the wounds and replacing them as they filled with blood.

The emergency contact told them not to use a tourniquet but just to wrap the towels as tight as they could.

The lady was going in and out of conciosness and the ambulance was about 10 minutes away.


Why were they not to use a tourniquet??? Surely that would have instantly slowed if not stopped the loss of blood. My understanding from courses done, admittedly many years ago, was that if released every 20 mins or so for a short period that it shouldnt cause any problems with the hands assuming she lives of course.

But the bottom line is that she needs to first live and hence stopping the blood loss would be paramount????


Apart from wanting to know because I have often found myself in emergency situations through my life and am likely to again in the future, I also have an interest because many many years ago i was among the first to an accident where a guy had his leg crushed in a head on and his leg was pretty much cut off..............I had a tourniquet on it to try and stop the blood loss. Is that now seen as the wrong thing to do?

 

[jts666]

just a guess, but would blood flow and clotting have something to do with it?? eg, reduced blood flow = reduced clotting agetns?? just having a wild guess here.....

if i were in this situation i would think tourniquet straight away.

 

[MazDan]

Anybody?

Surely we have some nurses and or docs in da house?

 

[Dave]

When you use a tourniquet it will stop the blood loss but it also pretty well kills whatever is after the tourniquet. Meaning that more surgery than necessary will need to be done to remove all the dead tissue and make a stump that will heal properly. If enough direct pressure is applied as soon as possible (i.e. without a tourniquet) it should slow the blood loss enough for EMTs to arrive and dress the wound properly and perhaps give a transfusion.

If you're in the middle of nowhere and it's a couple of hours before EMTs/Medevac shows up, then a tourniquet is pretty well the way to go. If you're in a city then it's more trouble than it's worth.

 

[Rabbi]

I seem to remember being told at my last first aid certification that tourniquets were no longer being recommended, and I believe it was for the reason that Dave stated.

I'm going to a recert in two weeks, so I'll post a better answer then if you haven't gotten one.

 

[MazDan]

OK I understand where you guys are coming from however wouldnt that also mean that the phone operator made a judgement call that may very well have backfired?

Meaning that if she underestimated the ammount of blood lost or the time it would take for an ambulance to get there etc then the person may have died as a result of her actions.

I would have thought that its better the person is 100% alive and possibly having to lose there hands than possibly 100%dead.

 

[Dave]

If the person called 911 immediately, then there would be no issue. If they waited for 20 minutes first, then they might well already be fucked, tourniquet or not.

 

[VerbalTruist]

If you use a tourney you can lose the limb or in some cases there can be death of the extremity. Unless its life threatening I've been told not to use one.

However, if the person was losing consciousness I would put one on there. No point in losing the patient.