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Why shouldn't tourniquet be used in first aid?


I heard in a first aid class that tourniquets are bad. That they can actually cause more harm to the victim. It can lead to possible amputation when removed due to the rush of blood to the area?
If someone can find a health document that has this information i would greatly appreciate it

Tourniquets

Once upon a time, every well-trained Boy Scout learnt how to stop bleeding with a tourniquet. But studies show this method causes more harm than good. "A tourniquet should never be used by an ordinary member of the public," says Kloeck, "except where a limb has been totally severed." Tourniquets can increase the risk of tissue damage or even the loss of a limb. Since there are other methods that can slow the blood flow - and preserve life - without the loss of the limb, tourniquets are out.

Better bet: Simply place a clean cloth on the wound and keep pressing firmly; don't remove the cloth, even if it gets saturated. If necessary, add more cloths on top of the first. Applying direct pressure reduces blood flow to the wound. This should stop the bleeding and promote clotting, but still leave blood circulating to the rest of the limb.

If that's not enough, you can further slow blood flow by applying pressure to the main artery of the upper arm or leg, depending on the site of the wound. You can learn about this procedure in a first-aid course, offered by such organisations as St John Ambulance ( www.stjohn.org.za).

They don't recommend them in a general first aid courses because things can go wrong as you have mentioned.

The main problem is the thickness of the bandage.
When you put a thin piece of string around a tree trunk pretty soon the string will eat into the trunk. A thick piece of cloth won't.
Recently a bloke got bitten by a shark. The first aid you have to use is a tourniqet because you have to stop the blood loss.
Tourniquets always have to be used if an artery gets cut because you just don't get enough pressure to stop the blood loss.

The other trick is to release it every 20 minutes a hard decision for a first aider to make.

Because you're trying to save a life a document such as the one you're asking for would only be available to Doctors.
Otherwise people might start suing you for bothering to help.
There's no black and white when you're talking seconds.

This is from my EMT Intermediate book by Brady. "Be extremely cautious if you consider using a tourniquet. Employ the device only to halt persistent, life-threatning hemorrhage. If the touniquet meets it's objective and halts all blood flow to the limb, blood loss stops, but so does circulation to the extremity. During this absence of blood, lactic acid, potassium, and other anaerobic metabolites accumulate in the stagnant blood. When the touniquet is released, the resumption of blood flow may transport these toxins into the central circulation with devastating results, including shock, lethal heart rhythms, renal failure, and death. It can also introduce emboli into the central circulation. If you have to apply a tourniquet leave it in place tell the patient arrives at the hospital. If you must use one make sure it is wide. BEFORE you consider a tourniquet try to control bleeding with pressure, elevation, and pressure points.

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