Proper Administration of an Emergency Tourniquet

I. Introduction

A. Attention Getter: Good evening ladies and gentlemen, my name is Jacob Johnson and tonight I am going to teach you how and when to properly administer a tourniquet, based on the same medical training I received in the Army from the Soldier's Manual and Trainer's Guide for the Health Care Specialist.

B. Thesis Statement: I am going to explain the proper steps to take when determining whether or not the use of a tourniquet is required and how to use one if the situation requires it.

C. Purpose Statement/Interactional Goal: Since the survival rates of those patients that received tourniquets before going into shock from loss of blood were significantly higher than those who received them late, or not at all, and it is my intention that by the end of this speech you have a basic knowledge of how and when to properly use a tourniquet in an emergency pre-hospital setting.

D. Significance: According to studies referenced in the article "Survival with Emergency Tourniquet Use to Stop Bleeding in Major Limb Trauma" from the Annals of Surgery's January 2009 issue #1, Dr. Walters and others have determined that of the patient cases where a tourniquet was indicated but not used, there was a 0% survivability rate, as opposed to the 87% survivability rate of those patients who did use a tourniquet.

E. Preview: Tonight you are going to learn the types of tourniquets, when to consider the use of a tourniquet, how to create a tourniquet, and how to properly administer one.

Transition: Let's get started by learning the types of tourniquets and what to do before using one.

II. Body

A. To the average person, a tourniquet is a cloth and stick device used to stop bleeding in an emergency situation due to traumatic injury.

1. While this is true and can be traced back to the ancient romans, there are multiple types of modern tourniquets available to you.

a. The aforementioned improvised cloth and stick device is what is known as a windlass tourniquet, and is widely used in the combat and emergency fields, and is also what you shall be learning how to make.

b. Another common variation is the Pneumatic tourniquet, which looks like a basic blood pressure cuff, and it is used widely in the surgical field.

c. There are other types available, such as clamp, ratchet, and block and tackle, but these are far less common variations.

2. Knowing when to use a tourniquet is just as important as knowing how. So as a general rule, the use of a tourniquet should be reserved for a last resort solution after all other attempts to stop the bleeding have failed and should only ever be used on extremities.

a. Simple methods for hemorrhage control such as dressing the wound with gauze or cloth and providing direct pressure to stop the bleeding should always be attempted first.

b. This is due to the fact that the longer a tourniquet is left on an extremity, the higher the probability of nerve damage and possible limb loss due to ischemia, which is the lack of new oxygenated blood flowing through the limb.

c. The Emergency Medical Journal article "Tourniquet Use in the Civilian Prehospital Setting" published in August 2007 by Lee, Porter, and Hodgetts, states that the use of a tourniquet can be allowed if "Benefits of preventing death from hypovolemic shock by cessation of ongoing external hemorrhage are greater than the risk of limb damage or loss from ischemia caused by tourniquet use." In easier to understand terms this means that if the benefits of saving a life by keeping them from bleeding out are worth more than the possibility of losing an arm or leg, the use of a tourniquet is advised but must be done quickly before the loss of blood becomes too great.

3. Once