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Severe Hemorrhage ControlSevere Hemorrhage Control
Application of theSof-T Wide Tourniquet
Application of theSof-T Wide Tourniquet
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Medical Director ApprovalMedical Director Approval
Before using tourniquets, all services must have: Patient care guideline (protocol) signed by the
medical director
Training, approved by the medical director, on the use of tourniquets
State EMS Unit approval of the protocol and training
Before using tourniquets, all services must have: Patient care guideline (protocol) signed by the
medical director
Training, approved by the medical director, on the use of tourniquets
State EMS Unit approval of the protocol and training
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ObjectivesObjectives
Discuss the indications, contraindications and considerations in the use of a tourniquet for hemorrhage control
Identify the steps required to control major hemorrhage with a Tactical Medical Solutions Sof-T Wide tourniquet
Review documentation and communication requirements of the procedure
Discuss the indications, contraindications and considerations in the use of a tourniquet for hemorrhage control
Identify the steps required to control major hemorrhage with a Tactical Medical Solutions Sof-T Wide tourniquet
Review documentation and communication requirements of the procedure
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IndicationsIndications
Severe bleeding of an extremity that is not controlled with direct pressure
Severe bleeding of an extremity when resources to provide direct pressure are limited MCI, tactical situation, difficult extrication
Severe bleeding of an extremity that is not controlled with direct pressure
Severe bleeding of an extremity when resources to provide direct pressure are limited MCI, tactical situation, difficult extrication
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Don’t wait!Application of a tourniquet before the patient goes into shock has been shown to improve outcomes in military studies
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ContraindicationsContraindications
There are no true contraindications to the use of a tourniquet when used to control life-threatening hemorrhage when direct pressure has failed or is not practical
There are no true contraindications to the use of a tourniquet when used to control life-threatening hemorrhage when direct pressure has failed or is not practical
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ConsiderationsConsiderations
Tourniquet application will likely be painful
Tourniquet application has been associated with tissue damage but this is generally minor and often temporary
Tourniquets are typically safe for up to two hours.
A tourniquet should never be removed without medical control consultation.
Tourniquet application will likely be painful
Tourniquet application has been associated with tissue damage but this is generally minor and often temporary
Tourniquets are typically safe for up to two hours.
A tourniquet should never be removed without medical control consultation.
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The Sof-T-Wide TourniquetThe Sof-T-Wide Tourniquet
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Quick-Release Buckle
Windlass
Triangle RingLoose End
Constricting Band
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ProcedureProcedure
Remove clothing and expose wound
Do not remove previously applied direct pressure
Remove clothing and expose wound
Do not remove previously applied direct pressure
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ProcedureProcedure
Disconnect the quick release buckle Disconnect the quick release buckle
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ProcedureProcedure
Route the band around the injured extremity
Place the band 2 – 3 inches above the wound Do not place it over a
joint
Route the band around the injured extremity
Place the band 2 – 3 inches above the wound Do not place it over a
joint
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ProcedureProcedure
Reconnect the quick release buckle
Remove the slack by pulling the loose end of the band
Reconnect the quick release buckle
Remove the slack by pulling the loose end of the band
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ProcedureProcedure
Turn the windlass to tighten the tourniquet
Tighten until major blood flow stops Slight seeping may still be present
Turn the windlass to tighten the tourniquet
Tighten until major blood flow stops Slight seeping may still be present
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ProcedureProcedure
Lock the windlass in place by slipping the triangle ring over the end of the windlass
Lock the windlass in place by slipping the triangle ring over the end of the windlass
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Triangle ring
End of windlass
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ProcedureProcedure
Note time of application
Keep tourniquet visible Do not cover with blankets
Ongoing re-assessment for return of active bleeding Tighten windlass, then
Apply 2nd tourniquet if bleeding remains active
Note time of application
Keep tourniquet visible Do not cover with blankets
Ongoing re-assessment for return of active bleeding Tighten windlass, then
Apply 2nd tourniquet if bleeding remains active
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Notify all caregivers involved in the care of the patient that a tourniquet has been placed
Notify all caregivers involved in the care of the patient that a tourniquet has been placed
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http://www.postindependent.com/article/20050621/VALLEYNEWS/50620012news.legalexaminer.com
ALS Ground Intercept ALS Air Intercept Emergency Room Reporthttp://www.bdems.com/med3.htm
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DocumentationDocumentation
Indication for tourniquet Severity of bleeding
Failure of direct pressure
Time of placement
Tourniquet location
Change in patient condition
Provider performing skill
Complications
Communication to hospital about tourniquet
Indication for tourniquet Severity of bleeding
Failure of direct pressure
Time of placement
Tourniquet location
Change in patient condition
Provider performing skill
Complications
Communication to hospital about tourniquet
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ComplicationsComplications
Consider placing a second tourniquet above the first one if severe bleeding continues
Generally, tourniquet application is safe for up to 2 hours
Contact medical control before loosening or removing a tourniquet
Consider placing a second tourniquet above the first one if severe bleeding continues
Generally, tourniquet application is safe for up to 2 hours
Contact medical control before loosening or removing a tourniquet
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