If the vessel is damaged and its integrity is impaired, blood begins to leak at the site of injury to the vascular wall. Damage to an artery is considered to be the most serious (if heavy bleeding from it is not stopped in time, a fatal outcome can occur literally in 3 minutes), and the most severe is damage to the capillary. A tourniquet helps to stop bleeding from a vein or artery (there is no sense in overlaying 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 failed in their task.
Drawback disadvantages
The tourniquet is applied to constrict the damaged vessel, however, this manipulation has certain health consequences:
- Compression of the surrounding tissue.
- The constriction of adjacent vessels.
- Compression of nerve endings.
- Disruption of tissue nutrition and oxygen delivery to the damaged part of the body.
What are the bleeding
Hemorrhage is distinguished by the area of leakage:
- Internal - blood flows into the body and forms a hematoma.
- External - flows out.
Depending on the type of damaged vessel, bleeding occurs:
- Capillary. The safest and slowest. Blood elements usually themselves form a blood clot and thereby stop bleeding. But it can be life-threatening - for diseases that provoke a decrease in the function of blood coagulability (for example, hemophilia or von Willebrand disease).
- Arterial. The pulsation of a bright red blood stream is characteristic. This species is the most dangerous for 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, vomiting reflex. If blood stops entering the brain, instant death occurs.
- Venous. Dark burgundy blood flows evenly, only a slight pulsation is possible. If a vein of significantly large size is damaged, then when inhaling in the vessel, the effect of negative pressure appears with an increased risk of air embolism in the heart vessels or in the brain in humans.
Internal bleeding and its intensity are precisely determined only with the help of special equipment.
In which situations a tourniquet is applied
An urgent tourniquet is necessary in the following circumstances:
- Arterial hemorrhage cannot be stopped by other means.
- The limb is torn off.
- Something foreign has fallen into the open wound, for this reason it is forbidden to press and just press the bandage.
- Very strong intense hemorrhage.
Rules for applying a tourniquet
To apply a tourniquet to a bleeding artery in accordance with all the rules, it is necessary to adhere to the sequence in actions:
- The part of the limb that is located above the injury site is wrapped in a towel or, if there is clothing, the folds of matter are straightened. It is necessary to try to apply a tourniquet as close to the wound from above as possible, not necessarily on the naked body, but on a cloth pad.
- Bleeding limb fits in an elevated position.
- The tourniquet is brought under the lower limb and is divided into 2 parts, the short part on the left and slightly longer on the right. The tourniquet stretches to the sides, and then wraps around a limb, crossing at the top. The long part of the tourniquet should lie above the short one and press it down.
- The tours following the first are superimposed without stretching.
- The remaining ends of the harness are tied or secured with a hook.
- If the tourniquet is applied correctly, then the hemorrhage should stop, the peripheral pulsation weaken, the skin of the limb itself will turn pale.
- Transportation of patients with tourniquet is recommended only in the supine position.
If we talk about applying a tourniquet to a vein, then you need to squeeze the vessel not as much as the artery, but it’s enough to stop the bleeding. With venous hemorrhage, the tourniquet is applied not higher, but lower than the wound, by about 8 cm. After applying the venous tourniquet, the pulsation of the artery under the wound should persist.
If it is not possible to use a pharmacy rubber tourniquet, then it is necessary to use any means suitable for this purpose that are at hand: a scarf, belt, scarf, etc.
How long can the harness be superimposed
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 application, 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 imposition (accurate to the minute) and the name of the person who applied the tourniquet. So that the note is not lost, it is placed directly under the bandage.
The maximum time for applying a venous tourniquet to the limb is 6 hours.
Features of the harness overlay depending on the season
The maximum time for applying the tourniquet in winter is recommended for half an hour less than in summer, i.e., in the summer it is standard 120 minutes, and in winter only 90 minutes.
But this is provided that the tourniquet will periodically weaken (the artery is pressed with a finger at this time). The continuous maximum time for applying the tourniquet in summer is 45 minutes, in winter 30 minutes, after which it is necessary to loosen the tourniquet for 5 minutes and fix it back.
In the winter cold season, you must not forget about the possibility of frostbite on the affected limb, so you need to insulate the place exposed for laying 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! Such babies use only pressing the vessel with a finger. After reaching the age of three, the maximum time for applying the tourniquet is 60 minutes in the summer. In this case, you need to loosen the tourniquet for 5 minutes after half an hour. In winter, for children over 3 years of age, the maximum time for applying a tourniquet is only 30 minutes.
For the elderly, there are no time limits. Therefore, for them, the maximum application time of the tourniquet is standard.