If the vessel is damaged and its integrity is broken, the blood begins to flow out at the site of injury to the vascular wall. Damage to the artery is considered the most serious (if heavy bleeding from it is not stopped in time, death can occur literally in 3 minutes), the easiest is damage to the capillary. A tourniquet helps to stop bleeding from a vein or artery (it makes no sense to apply it to compress smaller vessels). However, they impose it on the condition that all other possible measures to stop the bleeding have been tried, and they have not coped with their task.
Disadvantages of the tourniquet
A tourniquet is applied to constrict the damaged vessel, however, this manipulation has certain he alth consequences:
- Compression of surrounding tissue.
- Constriction of neighboring vessels.
- Squeezenerve endings.
- Impaired tissue nutrition and oxygen delivery to the damaged part of the body.
What are the types of bleeding
Hemorrhage is distinguished by the area of leakage:
- Internal - blood flows inside the body and forms a hematoma.
- Outer - flows out.
Depending on the type of damaged vessel, bleeding occurs:
- Capillary. The safest and slowest. Blood elements usually form a blood clot themselves and thereby stop the bleeding. But it can also be life-threatening - in diseases that provoke a decrease in the function of blood clotting (for example, hemophilia or von Willebrand disease).
- Arterial. The pulsation of a bright red blood stream is characteristic. This species is the most dangerous to life, because it leads to huge losses of blood supply in a short period of time. Consequences - pallor of the blood cover, weakened pulse, low blood pressure, dizziness, gag reflex. If blood stops flowing to the brain, instant death occurs.
- Venous. Dark burgundy blood flows evenly, only a slight pulsation is possible. If a significantly large vein is damaged, then when inhaling, a negative pressure effect appears in the vessel with an increased risk of air embolism in the heart vessels or in the human brain.
Internal bleeding and its intensity are accurately determined only with the help of special equipment.
In what situations is a tourniquet applied
Urgent tourniquet is required in the following circumstances:
- Bleeding from an artery cannot be stopped otherwise.
- Limb severed.
- Something foreign got into the open wound, for this reason it is forbidden to press and simply press with a bandage.
- Very strong intensive hemorrhage.
Rules for applying a tourniquet
To apply a tourniquet on a bleeding artery in accordance with all the rules, you must follow the sequence of actions:
- The part of the limb that is above the injury site is wrapped in a towel or, if there is clothing, the folds of matter are straightened out. It is necessary to try to apply a tourniquet as close as possible to the wound from above, not necessarily on the naked body, but on a fabric pad.
- The bleeding limb is placed in an elevated position.
- The tourniquet is brought under the bottom of the limb and is divided into 2 parts, a short part on the left and a little longer on the right. The tourniquet stretches to the sides, and then wraps around the limb, crossing at the top. The long part of the tourniquet should lie above the short one and press it.
- Tours following the first one overlap without stretch.
- The remaining ends of the tourniquet are tied or fixed with a hook.
- If the tourniquet is applied correctly, then the hemorrhage should stop, the peripheral pulsation should weaken, the skin of the limb itself will turn pale.
- Transportation of patients with a tourniquet applied is only recommended in the supine position.
If we talk about applying a tourniquet to a vein, then squeezethe vessel is not needed as strongly as the artery, but it is enough to stop the bleeding. In case of venous hemorrhage, the tourniquet is applied not above, but below the wound, by about 8 cm. After applying the venous tourniquet, the pulsation of the artery under the wound should remain.
If it is not possible to use a pharmaceutical rubber band, then it is necessary to use any means suitable for this purpose that are at hand: a scarf, strap, scarf, etc.
How long can a tourniquet be applied
The maximum time for applying an arterial tourniquet to a damaged vessel is 120 minutes, but this value may vary depending on the time of year and the age of the patient. With a longer imposition, the risk of necrosis (necrosis) in the tissues increases. To avoid injury from exceeding the maximum time for applying the tourniquet, use a note with the specified date, time of application (up to a minute) and the name of the person who applied the tourniquet. To prevent the note from getting lost, it is placed directly under the bandage.
The maximum time for applying a venous tourniquet to a limb is 6 hours.
Features of the harness lining depending on the season
The maximum time for applying a tourniquet in winter is recommended half an hour less than in summer, i.e. in summer it is standard 120 minutes, and in winter only 90 minutes.
But this is on condition that the tourniquet is periodically weakened (the artery is pressed with a finger at this time). The continuous maximum tourniquet application time in summer is 45 minutes, in winter 30 minutes, after which the tourniquet must be loosened for 5 minutes and fixed back.
In the cold winter season, you must not forget about the possibility of frostbite of the injured limb, so you need to insulate the place exposed for the tourniquet.
Age restrictions
If the child is not yet 3 years old, then applying a tourniquet to him on any part of the body is strictly prohibited! For such babies, only pressing the vessel with a finger is used. Upon reaching the age of three, the maximum time for applying a tourniquet is 60 minutes in the summer. In this case, it is required to loosen the tourniquet for 5 minutes after half an hour. In winter, for children over 3 years old, the maximum tourniquet time is only 30 minutes.
There are no time limits for the elderly. Therefore, for them, the maximum time for applying a tourniquet is standard.
