Tourniquet use

[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"

[DutchRN09]

1. Yes to start IV's

2. No

[PetiteOpRN]

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.

[mwboswell]

A little clarification folks - I'm talking about trauma tourniquets. Either military, tactical or EMS. The kind you put on to stop serious bleeding.

[mwboswell]

Just to clarify; I'm talking about emergency tourniquets (military, tactical or EMS) - the kind you use immediately to stop serious bleeding.

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"

[socalmedic]

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]

@SocalMedic: great info in your post. Thanks!

[Altra, BSN, RN]

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)

[Anna Flaxis, BSN, RN]

1) No.

2) Once, on a trauma pt., removed by the vascular surgeon.

[Lunah, MSN, RN]

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.

[nurse2033, MSN, RN]

I saw one recently on a traumatic amputation of the leg, the trauma surgeon removed it.

[dacaptain84]

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.