Tourniquet use

  1. 0 Questions about tourniquets:

    1) Are you using them?
    2) Are you receiving patients from EMS with them in place? If so, how do you manage them?

    Thanks!

    Mark Boswell
    MSN, FNP-BC, CEN, CFRN, CTRN, CPEN, NREMT-P
    "Support CEN Credentialing and your local ENA"
  2. Visit  mwboswell profile page

    About mwboswell

    mwboswell has '18' year(s) of experience and specializes in 'ER, Trauma, ICU/CCU/NICU, EMS, Transport'. From 'Southeast USA'; Joined Aug '06; Posts: 572; Likes: 398.

    19 Comments so far...

  3. Visit  DutchRN09 profile page
    0
    1. Yes to start IV's
    2. No
  4. Visit  PetiteOpRN profile page
    0
    1. Yes, typically pneumatic and adjusted based on blood pressure. Once they are up for 120 minutes, we let them down for 20.

    2. No.
  5. Visit  mwboswell profile page
    1
    A little clarification folks - I'm talking about trauma tourniquets. Either military, tactical or EMS. The kind you put on to stop serious bleeding.
    MassED likes this.
  6. Visit  mwboswell profile page
    0
    Just to clarify; I'm talking about emergency tourniquets (military, tactical or EMS) - the kind you use immediately to stop serious bleeding.



    Quote from mwboswell
    Questions about tourniquets:

    1) Are you using them?
    2) Are you receiving patients from EMS with them in place? If so, how do you manage them?

    Thanks!

    Mark Boswell
    MSN, FNP-BC, CEN, CFRN, CTRN, CPEN, NREMT-P
    "Support CEN Credentialing and your local ENA"
  7. Visit  socalmedic profile page
    1
    1. Yes, but as implied by my username I am EMS. We use the CAT tourniquet or a bp cuff. The CAT is easy, tighten untill pulse is lost distal or bleeding is controlled. For the bp cuff we inflate to 30mmhg higher than systolic or bleeding is controlled.

    2. If we have them on for greater than an hour we will loosten to allow bloodflow, or test the clot, then re apply if needed. We also use hemostatic dressings so we can usualy take them off after 30-45 min.

    2.5 the ed will remove them in the trauma suite at the direction of the trauma doc. I wish I had the protocol for hospital applied TQs but hope that helped...
    mwboswell likes this.
  8. Visit  mwboswell profile page
    0
    @SocalMedic: great info in your post. Thanks!
  9. Visit  Altra profile page
    0
    Only rarely do we see this in a patient coming in via EMS/HEMS - and it's usually a BP cuff. Only a couple of times have I seen a rigged-up "tourniquet" on a larger body part. I have never seen the device pictured in your post.

    (generally short EMS/HEMS transport times in my region)
  10. Visit  Anna Flaxis profile page
    0
    1) No.
    2) Once, on a trauma pt., removed by the vascular surgeon.
  11. Visit  Pixie.RN profile page
    0
    Quote from mwboswell
    Just to clarify; I'm talking about emergency tourniquets (military, tactical or EMS) - the kind you use immediately to stop serious bleeding.
    This is why people started referring to IV tourniquets as "constricting bands," to avoid confusion ... lol

    To answer your question: in the Army, we definitely have emergency tourniquets! However, I've only been in the ED, not yet downrange/deployed, and I have yet to see one. I'll have to ask my EMS peeps here if they have tourniquets, and protocols for them.
  12. Visit  nurse2033 profile page
    0
    I saw one recently on a traumatic amputation of the leg, the trauma surgeon removed it.
  13. Visit  dacaptain84 profile page
    1
    When I was in the army there response to just about everything was to apply a tourniquet....bleeding? Tourniquet! Headache? Tourniquet! I often wonder if they had a little better medical classes if they could save more lives or at the very least have more of our boys go home without missing limbs.

    Working in an OR we have used constrictive bands, but only for IV usage.
    tyvin likes this.
  14. Visit  pyroandbozzt profile page
    1
    I've probably use 9 or 10 during deployments to Iraq. On Iraqis and soldiers.

    Protocol was: if you have an extremity wound and are currently under fire and can get the wounded to the next level of care in under four hours, use a tourniquet. The medical staff can fix whatever damage is done but you'll keep the guy from bleeding out.

    Besides that, CAT tourniquets are easy. Open up, slide over extremity, use pole and tighten until bleeding stops, secure the pole. Works great. I've even seen it applied one handed by the guy missing the hand.
    Altra likes this.


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