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Proper Tourniquet Placement
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- Опубликовано: 28 окт 2016
- Are you confused on the proper placement of a tourniquet on an arm or leg? Your not alone in the confusion! Depending on what internet forum you read or video you watch you will hear either high and tight or a few inches about the wound. In this video I will help explain when do place the TQ hight and tight or when you can place it a few inches about the wound. Also hopefully clear up about placing a TQ on lower arms and legs where there are two bones.
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I had a military doctor tell me to place the tourniquet on a single bone area. I learned in a first aid course to use the two to three inches above the wound. Needless to say I was confused. The way you have explained it here is immensely more sensible. Thank you for this information. Excellent video.
Awesome!
Quite late but civilians are taught to put it few cm above wound while military on base of the joint. Has to do with +1 rule when you find critical bleeding wounds.
I myself am a survivor of high and tight.... with that said I'm sure there are situation that 2-3 inches may work.... i'll say it again.. may work.. but High and Tight always will give a better chance of survival.
As EMS providers we're held to proticals and sometimes have no choice of location.
It is proven that under stress we never rise to the occasion but revert back to the level of out training.
SkinnyMedic,
Thanks for all the effort and information, EMS can be so gray and it takes a special person to "put themselves out there" for others to criticize. Keep it up and stay strong.
i am a member of my local fire department and we actually had a incident were we needed to use tourniquet and some of the guys had trouble with it. i have watched this video a couple times and i am going to use it for training tonight since we are going over tourniquets. Thank you for the information that you have provided!!!
Awesome! I have a few different videos so maybe they will help. Sorry they had trouble!
Good points. I placed a TQ on a patient where there was arterial bleed at the forearm and I placed it high and tight because I was trained that way and it was easier to remember. Patient was saved.
Hey guys, I'm a medical student and admittedly no expert, but I just got out of a "stop the bleed" training scenario with a trauma surgeon and a very experienced life-flight medic. Both recommended that you place the tourniquet HIGH AND TIGHT-ALWAYS! The reason is, there is no advantage to placing it near the wound. They cited numerous studies that have shown limb tissue survives just fine after several hours of tourniquet use. The surgeon explained that she routinely stops bloodflow to limbs for hours at a time during surgery, and then opens up blood supply after the surgery is complete.
The take-away: Always place it high and tight and let the experts worry about the rest when you get the patient to the hospital!
Thank you, thank you, thank you! There have been a grunch of shooting channel videos regarding tourniquets of late, and all the ones I've been seeing were espousing 'High and tight' to the exclusion of any other approach. Your explanation brings back a sensible approach to the matter. Well done!
Thank you for the support!
Thanks for the great content. I watched this originally the day it came out.
Fast forward to today... I had this call.
Guy cut off his hand at the wrist with a radial arm saw.
TQ directly above the wound. If needed, we had a second TQ ready for the upper arm.
I can't thank you enough for all the information that you have shared with me through the years
I'm really glad I just found your channel! You have so much really valuable, easy to understand information. Please keep videos like this coming! Thanks!
Thank you for taking the time to help us all understand the questions around Tourniquet's. Ive learnt a lot in a short time.👍🏼 ☮️
Amazing video 👍 this was very helpful and easy to comprehend for beginners 🙌🏾😊
Thanks! I purchased your Tourniquet. I just got it today! I’ll learn from your RUclips channel now!
An artery, when severed can retract 2-3 inches. If you put the TK 2-3 inches above the injury site, and you're just on the edge of the artery or not at all because of the retraction, you've wasted valuable time and now need to take it off and move it up. Do it high and tight to avoid this possibility. You can indeed be successful applying the TK on the forearm, but it's likely not as fast as on the upper arm because of where the artery is located and single vs double bone (faster is better). There really is no reason not to do it high and tight. If you use a proper high-quality TK and apply it properly, there's not going to be any tissue or nerve damage (from the TK), and you're not going to lose the extremity (old school of thought). As an EMT-B, I just finished the NAEMT, TECC certification course and this is what they stressed. Also, when you're practicing self-application of your TK, you'll be able to crank it down tighter if you have it set up so you are pulling toward your midline, not away from you. When you are applying to a patient, you pull it toward, you to get it as tight as possible before cranking the windlass.
bhshakira, thanks all are good learning points.
Darn young fella! Now I have all this new stuff your teaching me all this stuff! GREATEST VIDEO IVE SEEN IN A LONG, LONG TY
Thanks SM! More knowledge I hope I will never need but I am grateful to have.
Skinny Medic: Your videos are gold.
Thank you!!!
Some classes I took discussed both methods but suggested fir those that do not handle stress very well but that person finds themselves as the first responder to just remember high and tight. That way there is no doubt of stopping flow of blood. I am no medical professional but have taken classes and courses so people have asked me what they should do. The first thing I say is take a course from a professional in the medical field. If you can't afford one or can't find a free one, then just go high and tight. I've seen examples of people that have tried to help but putting it 3 inches above the wound made them have to actually look at the wound and have seen people turn white and faint. Even on a practice dummy. Then later in the day, same scenario, they placed it high and tight, still were nervous and scared but they were able to apply the tourniquet properly without having to look directly at the wound. What are your thoughts for those of us that are not professionals but have above average training and a friend or family member asks us where to place it? Is it safe to tell them high and tight because you don't know what their stress threshold is?
Jonathan Zook, He never answered but great points. Many people will look at the wound and probably start vomiting. High and tight, see no evil , hear no evil.
Thanks Skinny Medic. I always enjoy your videos.
I can tell you're from Tennessee talking about kudzu.
Some great advice SkinnyMedic, thanks man.
Thank you!
Another great and informative video! Thank you for posting.
Splendid lesson as usual. Thanks brother 😀
The chainsaw demonstration was very helpful 👌 👍
Thanks for the info Skinny.
10cm above the wound if the situation allows you to inspect the limb, but not on the knee and not on the area up to 15cm above the knee because of the adductor canal blocking the artery.
Been an EMT since "73" (prefer Rescue more than ALS). Young man, your videos and content are EPIC..!!
Outstanding vid
Logan, 68W (ret)
Thank you!
Outstanding. Thanks for dropping the knowledge
Thank you for watching!
Awesome Video Sir..... Thank You for Sharing this.
Thanks Skinny. Good information.
Great information! Thank you sir!
Awesome video!!
Thank you
Amazing video. Thank you
Thank you..
I live in northern climates, in the winter, is there a chance that my medical bandages, etc. might freeze and stiffen up? This seems like a big deal. Should we reconsider how we carry our med gear, like an over the shoulder satchel that could be worn inside the coat?
Great Info, Thanks.
Dang. Working early. Good information. Best
Subbed! Ty!
Great Morty from Rick & Morty impression at the beginning there. :)
Lennart Nilsen Gotta love Rick and Morty lol
Legendary ❤
Hello, do you know the new Rhino torniquet?
Do you think abouth some video test In youtube, with you experience, do tou think is safe?!
Thanks for the video
Hi I know this video is old but I'm wondering if you've come across the "old" style Marine corp tourniquet? They looked a lot like a bandanna or triangular bandage with if I remember rightly a wooden toggle. I came across them back in my army days when we cross trained with some US Marines.
Thanks
How about applying ... two assuming two are available?
one high and one just above a identified wound
???
From TCCC perspective "high or die" is way to go.
If one works, there is no need for another. Save the other for later.
For civilian use it depends on scenario.
Is there professional help close by? Are the more than one in need of possible help.
Are you going along the patient? Are you the patient?
Basically if you put one above the wound and then apply another higher, the lower one is "useless".
If one works then there is no need for the second one. Apply 3" above if you can see the complete injuries, if not then high up.
correct
+SkinnyMedic a bit of a weird question, what would be a proper way to clean a tourniquet from mud and dirt?
So, any update on this?
I have a 1.5 y/o, so I'm trying to build two kits for our cars. What type of tourney for a baby/toddler? One size fit all? ty, sm
SWAT-T
Thanks for the info 👌
Thanks for another great video Skinny! Are there any tips you can give us for tourniquets on kids? Like 6, 7, 8 year olds?
Logic Bob I am 13 and i carry a tq but i have a lot of first aid training. So i wouldn't reccomend giving a tq to anyone under the age of 10 or 11 because they probably wouldn't understand when to use it.
Elias Salmi Thanks buddy but I was asking about APPLYING tourniquets to kids.
Oh ok.
@@eliassalmi3930 I would think the same process applies, if someone is injured to the point of needing a tourniquet, stopping the bleeding takes precedent over other concerns.
For 6-8 I would recommend RAT TQ or the SWAT TQ
So I had to put a tourniquet on a guy today. Was at a shooting competition and a guy shot himself in the leg. Went in at the side top of the calf and out the bottom of his calf while he was reholstering. All I heard was someone say "tourniquet" and I ran to my car to get my tk4 and ran back and put it high and tight on his leg. We were keeping him awake and talking and he seemed woozy but okay. The ambulance and came and was fine when they put him in there. Before the medics left though they asked was he bleeding badly when I put the tourniquet on and we all said "not too badly, but his leg and pants were bloody so we put it on". It was on for 20 or 30 minutes so they said if it wasn't bleeding bad they were gonna take it off. Anyway, I have no training at all. All I've done is watch videos on how to put on the tk4. My only question after all this is what's the definition of "bleeding badly"? It wasn't squirting out or anything but his leg and pants were all bloody. I'm still kinda shaken, wonder if I'll sleep tonight. Hope he makes a speedy recovery.
I would rather see you put on a TQ and the guy not need it than not put it someone and they bleed out. Sounds like you did the right thing. If EMS wants to take the TQ that is their issue.
SkinnyMedic when you apply the tq your cutting off the blood supply to the entire limb which obviously is going to make the tissue hypoxic, if the tissue is hypoxic long enough to cause muscle death which produces all kinds of nasty by products, when you release the tq, if done quickly your going to bolus the heart with all that nasty acidic waste from muscle death and probably kick you into a nasty arrhythmia which will probably kill you. When they release a tq that's been on for a while at the hospital they have to do it slowly while infusing sodium bicarb to keep your ph in check. Releasing the tq slowly is going to result in more muscle death which is going to end up with them loosing the limb all together. If a bleed is not arterial and can be controlled with pressure dressings it should be, you could save someone's limb. You will know an arterial bleed when you see one, forceful ejection or bright red blood.
If I have big and muscular legs or arm, the tourniquet can fail?
Just a question.
Mateus do Vale no, you will just have to use a lot of force to get it tight. But as long as you aren't a skinny female trying to cut off the bloodflow of mr universe it should be possible.
Mateus Do Vale , Carry atleast two tourniquets. If one doesnt do it , get to work with the second.
In the emergency most of us will not have torniquet. Can I use a belt?
Get rid of that poulan and get a real saw! Lol. Thanks for the video, man! Great info!
So, from all the videos I’ve see. Of the cat, I’m pretty sure I know the answer to this, and Sorry if this was already asked. I just want to confirm, is the loop that you slide up the arm or leg, all ready made(fixed in place) or do you have to tie the loop yourself? If it’s already made, the cat is what I should buy.
There is a loop you run the red-tipped end of the tourniquet through on your own, it isn't locked in place. Most people choose to prep/stage their tourniquets such that the loop is already ran through the loop, that way if you need to apply a tourniquet on yourself with one arm, you can.
Love your stuff
and love from australia
I'm in high school and I have the proper first aid training should I bring a tourniquet to school
I'm trying to purchase, keeps jumping pages?
medicalgearoutfitters.com/collections/tourniquets-holders
Is the CAT tourniquet made in the USA?
Yes
Thank you for this vid. Stuff like this save lifes! You're a part of it. Thank you for sharing it
( I have a new YT Channel named Herr Pischinger, I am still following you )
thanks
hey SkinnyMedic, love the vids! If i was going to put together a trauma kit, what would be the most essential items to buy? i don't have lots of money, and by trauma kit i mean any kind of trauma from a gunshot wound to a broken arm, even lacerations. thanks for your time!
C.A.T. (optional)
1x Israeli trauma bandage or similar (can be expensive. Maybe go for a standard large first aid dressing or two at first)
1x XXL trauma dressing (abdominal pad).
2x triangular bandage (sling, calico, sterile).
Trauma/tuffcut shears.
Surgical tape.
Gloves.
@@the_once-and-future_king. damn 5 years later and someone replied. you're a real one.
I think you spend the video talking about a this vs that debate...when all I want is the introductory concepts laid out first. A video called Tourniquet placement might not be a good title for comparisons of 2 schools of thought on the subject.
This is my 3rd video where I can’t really follow you man. You waited till the end to even mention your more basic video on this subject. I will check that out, but I just wanted to mention my frustrations with your ability to communicate your amazing knowledge to noobs.
Ok thank you for the feedback
I was always told that you put do "high and tight" during care under fire, and then put another 2-3 inches and take the old one off.
During tactical field care
Once again well covered and informed if I could only get half the knowledge in your brain into mine. Lol
I want some backyard chickens updates.
Look at this checkoutthehealthyworld.com/michigan-loses-right-farm-week-farewell-backyard-chickens-beekeepers/
Just above wound, and Tighter than you really realize. Tightness is more important than location. There has never been issues in past 20 years. Time has been made less and less importance due to the new medications use to recovery. The record for limb recovery has been about 28 hours. Jk PhD retired
I got a security warning when I attempted to download the .pdf.
SkinnyMedic i'm from Brazil and down here some agencies have prohibited the tourniquet because they claim that it can cause gangrene causing the arm or the leg to be amputated without that need...what do you think of that? they claim that are other ways to stop this type of massive bleeding like "pinch" the artery in his beginning of the arm or leg...tks
👍
Geez Morty is, is that you?
Use the Rick Grimes method. Cut the limb off with a hatchet and cartarize with fire.
I don't knows why there is so much confusion on this topic. It's not complicated.
Too bad you didn't show a single proper application of the tourniquet in this video. What was the point of showing those clips where you didn't apply it correctly?
witnessed a pedestrian leg removed and individual thrown 35 feet by high speed car bumper impact directly in front of me...
a long night ahead for all involved
and one fatality within seconds of impact
Someone is trapped under a car.
I lift the car, pull them out. No time for a tourniquet, 1 fist distance punch to the chest to stop the heart. Blood flow stops. I sear the open wounds using the exhaust pipe, my callused man hands feel no pain. One more punch to the chest and they are back. Several pretty girls have arrived at the scene, I give them my business card now and the business later.
I cannot recommend this technique for everyone, it is what I have done in the past for this scenario.
Perfect! This will be in my next video!
Folks....bottom-line up front..priority is Life over Limb, when in doubt whoop it out...high and tight...tell your story, write a book, make a movie!
Absolutely
tourniquettes are for beginners. Professionals open up an ak47 case with their teeth, put the powder on the arterie and cauterize it. Your Welcome!
I wondered if it's possible for a limb to be too skinny to use, for example a child arm or leg?
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