Use of tourniquets

Employing a Combat Application Tourniquet should only be considered after an accurate, thorough assessment of the threat to the life of the casualty, and where there is conviction that the life threatening bleed cannot be arrested or significantly reduced to a non-life threatening bleed using other means.

The modern tourniquet is a huge advance on primitive makeshift items, more effective, lives are saved, but the downside is still the same!

Considerations:

• A trauma which might involve the use of a tourniquet is one of the most difficult decisions a first aider will ever make.
• It is based on the conviction that it is necessary to sacrifice a limb to save a life.
• It is only considered when it is quite clear that other conventional means of arresting the bleed, or reducing it to a on-life threatening status cannot be achieved.
• The decision is taken in the full knowledge that even if the affected limb is not lost it will almost certainly be seriously disabled and may be without useful function.

Using a CAT tourniquet

• Applied to bare skin to avoid potential for slippage that might occur over clothing
• Apply snugly, 2” above the wound site.
• Tighten with the windlass until bleeding stops.
• Lock the windlass and secure with Velcro.
• Inadequate pressure that arrests venous flow but still allows arterial flow can make the bleed worse.
• Blood may continue to ooze from a broken bone.
• Do not release the pressure!
• The tourniquet is not released until the casualty is in the hands of professional medical care.
• A large ‘T’ should be written on the casualty’s forehead with the time of application to draw attention to it.