Tourniquets are indicated for severe bleeding from trauma to extremities where other methods of bleeding control have proven ineffective. Most bleeding can be controlled through direct pressure, elevation, and immobilization, but occasionally injuries can be significant enough to require tourniquet use.
Indications
Bleeding from an extremity that cannot be controlled through direct pressure or wound packing
Consider application for extremity crush syndrome *CliniCall consult required*
Contraindications
Procedure
Identify uncontrolled external bleeding.
Make one attempt at control with direct pressure.
If unable to control bleeding with direct pressure and the wound is on an extremity: position the tourniquet 5 – 8 cm above the injury, or as high on the limb as possible. Do not apply over joints. Remove clothing and ensure tourniquet is in direct contact with skin.
Secure tourniquet strap through the buckle, pull the strap until it is snug, and apply tension using the windlass until all bleeding has stopped. Lock the windlass into position and secure using the strap.
Note the time of application. Document the procedure in the ePCR.
Consider providing analgesia to the patient in accordance with CPG E08.
Notes
Tourniquets should not be in place for more than 2 hours. Contact CliniCall if scene management and/or transport times may exceed this timeframe.