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Severe Hemorrhage ControlSevere Hemorrhage Control

Application of theSof-T Wide Tourniquet

Application of theSof-T Wide Tourniquet

Medical Director ApprovalMedical Director Approval

Before using tourniquets, all services must have: Patient care guideline (protocol) signed by the

medical director

Training, approved by the medical director, on the use of tourniquets

State EMS Unit approval of the protocol and training

Before using tourniquets, all services must have: Patient care guideline (protocol) signed by the

medical director

Training, approved by the medical director, on the use of tourniquets

State EMS Unit approval of the protocol and training

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ObjectivesObjectives

Discuss the indications, contraindications and considerations in the use of a tourniquet for hemorrhage control

Identify the steps required to control major hemorrhage with a Tactical Medical Solutions Sof-T Wide tourniquet

Review documentation and communication requirements of the procedure

Discuss the indications, contraindications and considerations in the use of a tourniquet for hemorrhage control

Identify the steps required to control major hemorrhage with a Tactical Medical Solutions Sof-T Wide tourniquet

Review documentation and communication requirements of the procedure

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IndicationsIndications

Severe bleeding of an extremity that is not controlled with direct pressure

Severe bleeding of an extremity when resources to provide direct pressure are limited MCI, tactical situation, difficult extrication

Severe bleeding of an extremity that is not controlled with direct pressure

Severe bleeding of an extremity when resources to provide direct pressure are limited MCI, tactical situation, difficult extrication

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Don’t wait!Application of a tourniquet before the patient goes into shock has been shown to improve outcomes in military studies

ContraindicationsContraindications

There are no true contraindications to the use of a tourniquet when used to control life-threatening hemorrhage when direct pressure has failed or is not practical

There are no true contraindications to the use of a tourniquet when used to control life-threatening hemorrhage when direct pressure has failed or is not practical

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ConsiderationsConsiderations

Tourniquet application will likely be painful

Tourniquet application has been associated with tissue damage but this is generally minor and often temporary

Tourniquets are typically safe for up to two hours.

A tourniquet should never be removed without medical control consultation.

Tourniquet application will likely be painful

Tourniquet application has been associated with tissue damage but this is generally minor and often temporary

Tourniquets are typically safe for up to two hours.

A tourniquet should never be removed without medical control consultation.

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The Sof-T-Wide TourniquetThe Sof-T-Wide Tourniquet

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Quick-Release Buckle

Windlass

Triangle RingLoose End

Constricting Band

ProcedureProcedure

Remove clothing and expose wound

Do not remove previously applied direct pressure

Remove clothing and expose wound

Do not remove previously applied direct pressure

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ProcedureProcedure

Disconnect the quick release buckle Disconnect the quick release buckle

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ProcedureProcedure

Route the band around the injured extremity

Place the band 2 – 3 inches above the wound Do not place it over a

joint

Route the band around the injured extremity

Place the band 2 – 3 inches above the wound Do not place it over a

joint

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ProcedureProcedure

Reconnect the quick release buckle

Remove the slack by pulling the loose end of the band

Reconnect the quick release buckle

Remove the slack by pulling the loose end of the band

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ProcedureProcedure

Turn the windlass to tighten the tourniquet

Tighten until major blood flow stops Slight seeping may still be present

Turn the windlass to tighten the tourniquet

Tighten until major blood flow stops Slight seeping may still be present

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ProcedureProcedure

Lock the windlass in place by slipping the triangle ring over the end of the windlass

Lock the windlass in place by slipping the triangle ring over the end of the windlass

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Triangle ring

End of windlass

ProcedureProcedure

Note time of application

Keep tourniquet visible Do not cover with blankets

Ongoing re-assessment for return of active bleeding Tighten windlass, then

Apply 2nd tourniquet if bleeding remains active

Note time of application

Keep tourniquet visible Do not cover with blankets

Ongoing re-assessment for return of active bleeding Tighten windlass, then

Apply 2nd tourniquet if bleeding remains active

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Notify all caregivers involved in the care of the patient that a tourniquet has been placed

Notify all caregivers involved in the care of the patient that a tourniquet has been placed

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http://www.postindependent.com/article/20050621/VALLEYNEWS/50620012news.legalexaminer.com

ALS Ground Intercept ALS Air Intercept Emergency Room Reporthttp://www.bdems.com/med3.htm

DocumentationDocumentation

Indication for tourniquet Severity of bleeding

Failure of direct pressure

Time of placement

Tourniquet location

Change in patient condition

Provider performing skill

Complications

Communication to hospital about tourniquet

Indication for tourniquet Severity of bleeding

Failure of direct pressure

Time of placement

Tourniquet location

Change in patient condition

Provider performing skill

Complications

Communication to hospital about tourniquet

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ComplicationsComplications

Consider placing a second tourniquet above the first one if severe bleeding continues

Generally, tourniquet application is safe for up to 2 hours

Contact medical control before loosening or removing a tourniquet

Consider placing a second tourniquet above the first one if severe bleeding continues

Generally, tourniquet application is safe for up to 2 hours

Contact medical control before loosening or removing a tourniquet

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