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Severe Hemorrhage ControlApplication of the

Sof-T Wide Tourniquet

Medical 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

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Objectives

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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Indications

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

Contraindications

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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Considerations

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 Tourniquet

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Quick-Release BuckleWindlass

Triangle Ring Loose End

Constricting Band

Procedure

Remove clothing and expose wound Do not remove previously applied direct pressure

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Procedure

Disconnect the quick release buckle

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Procedure

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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Procedure

Reconnect the quick release buckle Remove the slack by pulling the loose end of the

band

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Procedure

Turn the windlass to tighten the tourniquet Tighten until major blood flow stops

Slight seeping may still be present

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Procedure

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

Procedure

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

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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

Documentation

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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Complications

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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