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Tourniquets for the EMS Provider. Connecticut EMS Advisory Board Education and Training Committee Revised April, 2013. Goals. Program goals are to: Provide participants with information regarding bleeding control - PowerPoint PPT Presentation
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Tourniquetsfor the EMS
ProviderConnecticut EMS Advisory BoardEducation and Training Committee
Revised April, 2013
Goals Program goals are to:
Provide participants with information regarding bleeding control
Provide participants with alternative methods of controlling bleeding when direct pressure is not effective
Objectives At the end of the program, the student will
be able to: Discuss current techniques for hemorrhage
control Describe indications and contraindications of
tourniquet use Describe the application process Describe the change in the bleeding control
algorithm
Introduction Hemorrhage control
Previous Technique Direct pressure Pressure dressing Elevation Pressure point compression
New Recommendation
“The use of ‘elevation’ and pressure on ‘pressure points’ is no longer recommended because of
insufficient data supporting their effectiveness” (PHTLS, 7th Ed, 2011. p.115)
New Recommendation Hemorrhage control
Direct pressure Pressure dressing Tourniquet (PHTLS, 2011)
Indications
Hemorrhage from an extremity that cannot be controlled with direct pressure or a pressure bandage
Contraindications
There are NO contraindications to tourniquet application when faced with
the appropriate clinical situation
REMEMBER…
Tourniquets can be used for: Life threatening extremity
hemorrhage When direct pressure or pressure
dressing can not be applied
•Not all bleeding wounds require tourniquet application!
Tourniquets Not Necessary when..
Bleeding that Requires a Tourniquet
Improvising… Although a tourniquet can be
improvised, it is recommended that a commercially available and thoroughly
tested tourniquet be used Input from EMS Sponsor Hospital/
EMS Medical Director may be helpful
Improvised Tourniquet Necessary items:
Tourniquet band At least 2 inches wide
Rigid object Stick that is strong enough to tighten the tourniquet and be secured
Padding Material placed between the limb and the tourniquet band
Securing materials Material that will secure the rigid object once tourniquet tightened
Improvised Tourniquet
Improvised Tourniquet
Various Types of Commercial Tourniquets
Commercial Tourniquets Variety of types
Remember ! Must be trained on the specifics of the device Must follow specific manufacturers’ guidelines
for application EMS Sponsor Hospital/ EMS Medical Director
input on tourniquet selection is recommended
Application (1of 3)
2-3 inches above the wound
Watch for other sites of bleeding above the wound
Multiple bleeding sites proximal application
Application (2 of 3)
Should be tight enough to stop bleeding The tourniquet should never be placed
Joint (knee or elbow) Over an impaled object
Extremity should be exposed Document application time
Write on patient!
Application (3 of 3)
A prehospital tourniquet should not be removed by EMS personnel without
authorization from their EMS Sponsor Hospital/Medical Direction
If application exceeds six hours, removal should only be done by the physician providing definitive care
Pearls Time of tourniquet application should be
relayed to each provider that assumes care
Instruct patient to inform every care provider that they come in contact with that a tourniquet has been placed and its location
Questions ?
Special Thanks to Dr. Richard Kamin for his time and effort in the development of this program
Ralf Coler and Terry DeVito for their project coordination
Advisory Board, State of CT Education and Training Committee
ACKNOWLEDGEMENT
Bibliography
Doyle GS, Taillac PP. Tourniquets: a review of current use with proposals for expanded prehospital use. Prehosp Emerg Care.
2008 Apr-Jun;12(2):241-56.
Prehospital Trauma Life Support, Seventh Ed. Mosby, Inc. 2011
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