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Jama Galante 2017 PG 150030

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53 views1 page

Jama Galante 2017 PG 150030

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Slovodan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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JAMA PATIENT PAGE | Trauma

Using Tourniquets to Stop Bleeding


After the April 15, 2013, Boston Marathon bombings, 27 patients with life-threatening bleeding
were saved by placement of tourniquets by people at the scene.
What Is a Tourniquet? Applying a tourniquet with a windlass device
A tourniquet is a device that is placed around a bleeding arm or leg.
Apply direct pressure 1 Place a 2-3” strip of material
Tourniquets work by squeezing large blood vessels. The squeezing to the wound for about 2” from the edge
helps stop blood loss. at least 15 minutes. of the wound over a long bone
between the wound and the heart.
Use a tourniquet only
How Do I Put a Tourniquet On? when bleeding cannot
be stopped and
Tourniquets can be made out of any available material. For ex- is life threatening.
ample, you can use a bandage, strip of cloth, or even a t-shirt. The
material should be at least 2 to 3 inches wide. The material should
also overlap itself. Using thin straps or material less than 2 inches wide
can rip or cut the skin.
Tourniquets often use a windlass device to increase tighten- 2 Insert a stick or other strong, straight
ing. Inflated tourniquets (for example, those made from blood pres- item into the knot to act as a windlass.
sure cuffs) can work well. But they must be carefully watched for
small leaks.
The injured blood vessel is not always right below the skin
wound. Place the tourniquet between the injured vessel and the
heart, about 2 inches from the closest wound edge. There should
be no foreign objects (for example, items in a pocket) beneath the
tourniquet. Place the tourniquet over a bone, not at joint.
3 Turn stick to tighten tourniquet
What Else Do I Need to Know? until pulse below the tourniquet
cannot be felt.
All bleeding should stop soon after you tighten the tourniquet. You
must place a second tourniquet above the first if bleeding does not
stop and you cannot tighten the tourniquet, or if the arm or leg swells
above the tourniquet.
Once bleeding is controlled 4 Secure windlass in place
with a second piece of material.
• Mark the time on the arm or leg
• Keep the tourniquet visible
• Check the arm or leg every 2 hours for
• Swelling
• New bleeding
• Increased muscle stiffness Keep tourniquet visible and monitor wound for bleeding.
Note time and watch for swelling below tourniquet.
Do not remove or loosen the tourniquet until professional
care is available.

FOR MORE INFORMATION


About Health: How to Use a Tourniquet
http://firstaid.about.com/od/bleedingcontrol/ss/07_tourniquet
.htm#showall

Author: Joseph M. Galante, MD The JAMA Patient Page is a public service of JAMA. The information and
Source: King DR, Larentzakis A, Ramly EP; Boston Trauma Collaborative. Tourniquet recommendations appearing on this page are appropriate in most instances, but they
use at the Boston Marathon bombing: lost in translation. J Trauma Acute Care Surg. are not a substitute for medical diagnosis. For specific information concerning your
2015;78(3):594-599. personal medical condition, JAMA suggests that you consult your physician. This page
may be photocopied noncommercially by physicians and other health care
professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

1490 JAMA April 11, 2017 Volume 317, Number 14 (Reprinted) jama.com

Copyright 2017 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ on 04/17/2022

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