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Thursday, April 22, 2010

When to apply a tourniquet

"All bleeding stops eventually"
Disclaimer: Please keep in mind that the guidlines are constantly changing.
When to apply a tourniquet is very important. I’m sure you’ve heard lots of rumors as to why or why not applying a tourniquet is bad. Let me clear the air of confusion. You’ve heard that applying a tourniquet to a limb will cut off the blood supply and kill the limb. This is true… if you leave it on for days however a tourniquet can be applied for several hours without any damage on the cellular level. Surgeons leave tourniquets on for up to two hours while doing surgery on the legs. So what is the big deal? When a tourniquet is applied it causes the blood in that limb to become stagnant (not moving) blood that isn’t moving tends to form clots. Clots in the bloodstream are never a good thing. Clots can stay in the limb and continue to cut off blood supply which will eventually lead to tissue damage or worse they could break free and end up in your lungs or brain. I know you just had an “Ah Ha” moment. You see when surgeons put a tourniquet on they always test your blood for coagulation factors and give you medication to thin the blood or stop it from coagulating. The longer the tourniquet is on the higher the risk for blood clots forming. Everybody has a different coagulation time and so there is no set time to how long a tourniquet can be on before running the risk of clots forming. There are two rules of thumb I like to use. #1 never put a tourniquet on a limb you aren’t willing to lose. #2 it’s better to lose a limb than a life. Keep in mind that if you can stop the bleeding by applying direct pressure, this is always the preferred method. All bleeding stops eventually, the sooner you can stop it the better the out come.

P.S. I'm sorry I assumed everyone knew how to make a tourniquet. For instructions on how to make one, go to the “Tourniquet” blog I posted.

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