When a person suffers a traumatic wound they may experience severe bleeding. As the average adult has 5 liters of blood circulating at any given time, severe blood loss can easily become life-threatening and should be treated as a medical emergency.
In some cases, a tourniquet may be required to help control the bleeding before paramedics can arrive at the scene. When blood loss cannot be stopped with direct pressure, a tourniquet could save someone’s life.
However, the use of tourniquets comes with a number of risks. It is important for first responders as well as the public to understand when to use a tourniquet and how to apply one correctly.
What is a tourniquet?
A tourniquet is a device that is wrapped around a person’s arm or leg to help control severe bleeding from a life threatening wound.
When tightened, a tourniquet will squeeze the blood vessels in the affected limb, prohibiting blood flow to the area in order to reduce blood loss.
Commercially made tourniquets are purpose built to effectively control blood loss, however if one is not available a tourniquet can be improvised using readily available materials.
Are tourniquets safe to use?
Tourniquets can be effective at saving a person’s life if direct pressure fails to stop the bleeding, however they should only be used in life threatening situations as a last resort.
Restricting blood flow to the affected limb means that the tissues in that limb, such as skin, muscle and nervous tissue, will not receive oxygen. This can cause tissue damage and even tissue death.
In some cases, the use of a tourniquet can lead to limb amputation. Amputation is preferable to the loss of life so a tourniquet should be used if other options have not stopped the bleeding.
When should you use a tourniquet?
Tourniquets should only be used if it is not possible to stop the bleeding with direct pressure or if it is not possible to apply direct pressure.
For example, if there are multiple casualties that need attention, if the person has several life threatening wounds that need attention or if the wound is inaccessible.
Situations where a tourniquet might be appropriate include car accidents, gunshot wounds, crushed limbs and deep cuts.
Tourniquets can only be used on wounds that have occurred on the arms or legs, they cannot be used for injuries to the torso or head.
How to control bleeding – first treatments
A person can die from severe bleeding within minutes. Call 000 for emergency help as soon as possible.
- Check for danger and move the injured person to a safe place if necessary. Sit them or lie them down, whatever is most appropriate for the type and location of the injury.
- If possible, raise the injured limb higher than heart level to reduce blood flow to the affected area.
- Then inspect the wound to determine the nature and location of the wound and the amount of blood loss. Do not remove any deeply embedded objects.
- Place a bandage or cloth on the wound site and press firmly with your palm. Continue to apply pressure until the bleeding stops. This can take over 10 minutes. Do not apply direct pressure to an embedded object.
- If the bleeding fails to stop, a tourniquet can be applied on the limb above the wound.
How to apply a tourniquet
- Slip the band around the affected limb and slide it up above the wound. Position it more than 5cm above the wound, but not on a joint such as the knee or elbow.
- If you cannot slide the tourniquet over the limb, you can secure it in place using an alternative wrap around method.
- Turn the windlass (the straight handle) to increase pressure. Continue winding until the bleeding has significantly reduced or stopped completely. Secure the windlass in place to prevent it from unwinding.
- Write down the time that you applied the tourniquet somewhere visible as paramedics will need this information when they arrive. Tourniquets cannot be used for long periods of time.
How to make an improvised tourniquet
It is preferable to use a medical grade tourniquet as they are purpose built, more reliable and more effective.
However, if a medical grade tourniquet is not available, you can improvise one out of materials that you have on hand.
For the band, choose something that is fairly thick like a scarf, ripped up clothing or a belt. Don’t use any thin items like string, wire or shoelaces as these can cause serious damage.
Use something rigid as a windlass such as a stick, broom handle or jack. Wind the outside layer of the band around the windlass to secure it and then turn the windlass to increase pressure.
Essential first aid equipment for severe bleeding
If you are responsible for the health and safety of employees, students or the public, it is crucial to be prepared for emergency situations.
That includes being stocked with the correct wholesale medical supplies and equipment to handle medical emergencies.
Bleed control kits are designed to help provide first aid for traumatic wounds. They are used by many workplaces and first responders including surf lifesaving, police and parks and wildlife officers.
All bleeding control kits should be equipped with:
- Thermal blanket
- Medical grade tourniquets
- Sterile gloves
- Haemostatic gauze
- Small, medium and large wound dressings (from Aero Healthcare supplies or similar)
- Medical grade scissors
Kits for bleeding control, traumatic wound care and essential first aid can be purchased from wholesale medical suppliers.
