April 18, 2018 0 Comments

What Is A Tourniquet

Tourniquet Defined:

A device for stopping the flow of blood through a vein or artery, typically by compressing a limb with a cord or tight bandage.

There are currently two types of tourniquets available: 

Pneumatic

Inflatable, primarily used in hospital / surgical settings.

Non-Pneumatic

Not Inflatable, primarily used in pre-hospital settings.

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PNEUMATIC TOURNIQUETS: Pneumatic tourniquets are routinely used in surgery to create a blood less area for surgical teams to work. Current estimates are that pneumatic tourniquets are used in 15,000 surgeries each day. Technological advances such as automatic computer controlled systems have increased the safety and efficacy of these devices. The probability of tourniquet injury or complications is well documented to be correlated to higher pressures, and higher pressure gradients near the edges of a tourniquet.

NON-PNEUMATIC TOURNIQUETS: Traditional designs of non-pneumatic tourniquets generally consist of narrow strips of material that employ a simple tool that facilitates a mechanical advantage, and allows for the securing of said tool to maintain required occlusion pressure.

What's New?

In recent years newer non-pneumatic tourniquets also known as emergency, commercial, or pre-hospital tourniquets have evolved. While traditional tourniquets were originally made for soldiers, thus used the lightest and least amount of material possible, newer innovations have maintained those characteristics into a wider, and therefore, safer non-pneumatic tourniquet.

For example, the true functional area of traditional tourniquets are 1" - 1.5" wide (2.54 - 3.81 cm), with some using a 1" (2.54 cm) strip of material within a 1.5" (3.81 cm) material sleeve. Newer tourniquets have increased their widths to 2" or more (5.08 cm or more). This increase in width allows the tourniquet when applied to compress the tissues of the limb to occlude the artery at lower (safer) pressures. 

Figure 1: Applied pressures and pressure gradients typically produced by (a) a modern pneumatic surgical tourniquet cuff, (b) a non-pneumatic, non-surgical military tourniquet designed for self-application, and (c) a non-pneumatic elastic ring designed in an attempt to combine exsanguination and tourniquet functions.

Recommendations:

1. For normal sized adults a non-pneumatic tourniquet with a width of 2" or more should be used.
2. Only use tourniquets from verified commercial manufacturers. Legitimate manufacturers will be registered with the FDA, TGA, or similar government health organization. This information is typically listed on the footer of their websites along with any quality management systems in place (which are required by law). 
3. Ebay sellers are not reputable sources for tourniquets. There are a lot of counterfeiters out there that attempt to cheat the system with cheap knockoffs that circumvent good manufacturing practices, quality management system requirements, and government health organization regulation, therefore, putting your life in jeopardy. If anyone tells you to go to Ebay to buy a tourniquet from a random seller, even if they are a "Doctor" don't.
4. Improvised Tourniquets. Using whatever materials are on-hand or nearby in a life-threatening situation may be necessary to control bleeding and survive. Statistically, improvised tourniquets have been found to fail 75% of the time, create complications, and pose a greater risk of making matters worse.  Improvised or makeshift tourniquets should only be used as a last resort, when an actual pre-hospital tourniquet is not available.

SOURCES:

www.tourniquets.org

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