needed to close the artery (fig. 10-39, view H). If
bleeding is not controlled, it may be necessary to press
directly over the artery with the flat surface of the
fingertips and to apply additional pressure on the
fingertips with the heel of the other hand.
Tourniquet
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
Figure 10-40.--Applying a tourniquet.
A tourniquet may be dangerous. Its
application may cause tissue injury or even loss
Make sure you draw the tourniquet tight enough
of the injured limb. It is only rarely required and
to stop the bleeding but do not make it tighter than
should be used only in cases of partial or
necessary.
complete severance of a limb or when bleeding
Never loosen a tourniquet once it has been
is uncontrollable.
applied. The loosening of a tourniquet may dislodge
clots and result in enough blood loss to cause severe
The standard tourniquet is usually a piece of web
shock and death.
belting about 36 inches long, with a buckle or snap
device to hold it tightly in place when applied. A
Do not cover a tourniquet with a dressing. If it is
tourniquet can be improvised from a strap, belt,
necessary to cover the injured person, make sure all the
neckerchief, or other similar material. A tourniquet
other people concerned with the case know about the
should be at least 2 inches wide to distribute pressure
tourniquet. Using crayon, skin pencil, or blood, mark a
over tissues. Never use wire, cord, or anything that will
large "T" on the victim's forehead and on a medical tag
cut into the flesh.
attached to the victim's wrist. The time the tourniquet
was applied must also be indicated.
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.
Armpit Tourniquet
Place a short stick on the overhand knot, and tie a square
knot over it. Then twist the stick to tighten the
A deep wound high up on the arm or an amputation
tourniquet. The stick may be tied in place with another
at the upper part of the arm may require a tourniquet at
strip of material. Figure 10-40 demonstrates the proper
the armpit to control bleeding. If needed, apply as
method for applying a tourniquet.
follows:
The following are major points that you must know
1. Place the center of a narrow cravat bandage in
about the use of a tourniquet:
the armpit over a firm pad or padded object.
Do not use a tourniquet unless you cannot control
2. Cross the ends on the shoulder over a pad.
the bleeding by any other means.
3. Carry the ends around the back and chest to the
Only use a tourniquet on an arm or a leg.
opposite side and tie them over the pad.
Always apply a tourniquet between the wound
4. To tighten, insert a small stick or smaller object
and the heart, making it as close to the wound as
under the cross of the bandage on the shoulder and twist.
Twist only until the bleeding is controlled. Then secure
possible. When the wound is just below the elbow or
knee, the tourniquet may have to be placed above the
or anchor the stick to prevent untwisting (fig. 10-40,
joint to get good compression on the limb.
view D).
10-21
