Improvised tourniquets
Do not stop the bleeding. They compress veins only, not the deep arteries.
Hypoperfusion / shock is a trigger !
Causes limb compartment syndromes with necrosis and local infection.
Infection is a trigger !
Are left for hours with hypoperfusion, and thus create reperfusion syndromes.
Reperfusion is a trigger !
Are very painful for the patients.
Pain is a trigger !
Don’t use tourniquets, but pack the bleeding wounds
To manage bleeding, use this strategy:
1. One helper elevates the bleeding limb. Keep it elevated!
2. One helper compresses the proximal artery against the bone. Keep the pressure steady!
3. Pack any clean (or dirty) cloth deep into the wound track. Work carefully, all pockets of the wound should be filled up with cloth!
4. Apply a long compressive elastic bandage from the toes/finger to the groin/axilla.
5. Now let the artery compression off slowly. If bleeding starts again, start compression again and apply another compressive dressing outside the first one.