Use of Arterial Tourniquets [Micro Lecture]

In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about how to manage the Training Arterial Tourniquets.

Today we’re going to talk about haemorrhage control. Now, haemorrhage control is determined by the rate and speed of the haemorrhage. So for example, if you’re dealing with catastrophic haemorrhage, you really do need to act extremely quickly and you also need to be very precise as to what you do and how you do it. If you’re looking at a patient who does not have catastrophic haemorrhage but is still bleeding and is at risk of infection, you still have to maintain control of that and cover the wound using a range of dressings to prevent further infection.

Now, when you’re dealing with catastrophic haemorrhage, you really do need to act quickly. Now to do this, you need to be familiar with your ambulance services tourniquets or use of hemostatic devices, hemo just meaning blood and static, meaning stopping or stay static as in stasis, standing still.

Now, there are many different arterial tourniquets on the market and if you literally just type into your search engine, tourniquets or arterial tourniquets, it will show you all these different devices. Now think about what you’re trying to do. You’ve got an artery that’s bleeding, openly bleeding. Think about what arteries are. They are vessels that carry blood away from the heart and under high pressure and they carry oxygenated blood. So you’re in a situation where you’re trying to stop that bleeding. Now, the first thing you would do is to try direct pressure and elevate the limb if it’s on a limb. If it’s not on a limb, it’s just direct pressure straight away without any thought, just directly over the lip, over the arterial bleed.

Now, ideally, you want to have your gloves on just to prevent infection or injury to yourself. You also want to try and use some kind of clothing or clean dressing. But if that doesn’t work, you just need to keep putting dressings on top and on top. Now, ambulance services do have a range of dressings for that. They have small, medium, and large dressings. They have extensive abdominal wound injury dressings, and they also carry arterial tourniquets. So if the arterial bleed is on one of the limbs, let’s say for example the femoral artery, you can use one of these arterial tourniquets. Now let’s just take this tourniquet here, for example. These are the same. Now you put the claim through the hole, through the device if it hasn’t already been clipped. So you clip it if it hasn’t been clipped. Put the limb through or even put it around the limb and clip it.

Remembering that this is a very fast process. Your patient’s losing a lot of blood. You put it tight using these straps. Then you twist this buckle and clip it in here. Now you will be able to practice this at the workshops. Obviously, you won’t be able to completely sever your arterial circulation. But that’s exactly what this does. It stops the arterial circulation into that limb. Meaning you’re likely to experience some type of nerve damage, some kind of muscle damage. When you’re using these, you apply it is as close to the point of attachment as possible. You don’t lift it up to check to see if it’s stopped bleeding. And when you’re twisting the arterial device, the mechanism, you only apply as much pressure to stop the arterial bleed. You don’t keep twisting it just for the sake of twisting. So that’s one way of using the devices.

Now also understand that there’s a lot of research currently going on as to the best device to use, the length of time to use it, whether or not tranexamic acid should be used with. Tranexamic acid is a drug that causes blood clotting and helps to stop internal bleeding. And of course, don’t forget you also have types of dressing that are laced with types of hemostatic agents as well.’

One final comment about arterial tourniquets is that you must put the time somewhere on the device or at worst case scenario, document it and hand it over to the nursing staff. Okay guys, thanks very much for your attention. I look forward to speaking with you again shortly. Cheers. Take care.

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