A tourniquet should be used only as a last resort for severe, life-threatening hemorrhage that cannot be controlled by any other method. First-aiders should thoroughly understand the dangers and limitations of its use.

CAUTION

A tourniquet may be dangerous. Its application may cause tissue injury or even loss of the injured limb. It is only rarely required and should be used only in cases of partial or complete severance of a limb or when bleeding is uncontrollable.

The standard tourniquet is usually a piece of web belting about 36 inches long, with a buckle or snap device to hold it tightly in place when applied. A tourniquet can be improvised from a strap, belt, neckerchief, or other similar material. A tourniquet should be at least 2 inches wide to distribute pressure over tissues. Never use wire, cord, or anything that will cut into the flesh.

To apply an emergency tourniquet made from material resembling a cravat or neckerchief, wrap the material once around the limb, and tie an overhand knot. Place a short stick on the overhand knot, and tie a square knot over it. Then twist the stick to tighten the tourniquet. The stick may be tied in place with another strip of material. Figure 10-40 demonstrates the proper method for applying a tourniquet.

The following are major points that you must know about the use of a tourniquet:

l Do not use a tourniquet unless you cannot control the bleeding by any other means.

l Only use a tourniquet on an arm or a leg.

l Always apply a tourniquet between the wound and the heart, making it as close to the wound as possible. When the wound is just below the elbow or knee, the tourniquet may have to be placed above the joint to get good compression on the limb.

Figure 10-40.-Applying a tourniquet.

l Make sure you draw the tourniquet tight enough to stop the bleeding but do not make it tighter than necessary.

. Never loosen a tourniquet once it has been applied. The loosening of a tourniquet may dislodge clots and result in enough blood loss to cause severe shock and death.

l Do not cover a tourniquet with a dressing. If it is necessary to cover the injured person, make sure all the other people concerned with the case know about the tourniquet. Using crayon, skin pencil, or blood, mark a large "T" on the victim's forehead and on a medical tag attached to the victim's wrist. The time the tourniquet was applied must also be indicated.