Tourniquet Hemostasis

When other methods of hemostasis are ineffective for bleeding from larger upper and lower limb arteries, a tourniquet can be used to stop bleeding. There are two types of tourniquets: rubber and cloth. In emergency treatment, you can use local materials such as wide leather strips, triangular bandages or towels instead.
(1) Indications: Since the use of a tourniquet can easily cause physical disability, the indications must be strictly controlled. When a tourniquet must be used, the pressure must be appropriate, and should not exceed 300 mmHg for the upper limbs and 600 mmHg for the lower limbs. If it is a simple tourniquet and the pressure cannot be measured, it can only be applied until the wound does not bleed and the distal limb arterial pulsation is just untouchable.
(2) Precautions: ① The tourniquet cannot be wrapped directly on the skin, but must be placed on a flat mat made of a towel, triangular bandage, etc.; ② The tourniquet should be placed close to the wound at the proximal end of the wound; ③ To avoid nerve damage with the tourniquet, the upper limb should be tied at the upper 1/3, and the lower limb should be tied at the middle of the thigh; ④ To prevent ischemic necrosis of the distal limb, under normal circumstances, the tourniquet should not be applied for more than 2 to 3 hours, and it should be relaxed every 40 to 50 minutes to temporarily restore blood flow to the distal limb; ⑤ After the tourniquet is applied, it should be marked and the time should be noted; ⑥ Note that it is strictly forbidden to use iron wire, electric wire, rope, etc. instead of a tourniquet.
When using a rubber tourniquet, hold one end of the tourniquet with the thumb, index finger and middle finger of your left hand, tighten the tourniquet with your right hand and wrap it around the limb for two weeks, then put the end of the tourniquet between the index finger and middle finger of your left hand, clamp the tourniquet with the index finger and middle finger, and pull it out to secure it; when using a cloth strip or other cloth substitute, first wrap the cloth strip loosely around the limb and tie a knot, then pass a short wooden stick under the knot, tighten the wooden stick, and rotate it in one direction to wrap the cloth strip tightly around the limb until the wound stops bleeding.