Using Tourniquets to Stop Bleeding | Emergency Medicine | JAMA | JAMA Network
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JAMA Patient Page
April 11, 2017

Using Tourniquets to Stop Bleeding

JAMA. 2017;317(14):1490. doi:10.1001/jama.2015.8581

After the April 15, 2013, Boston Marathon bombings, 27 patients with life-threatening bleeding were saved by placement of tourniquets by people at the scene.

What Is a Tourniquet?

A tourniquet is a device that is placed around a bleeding arm or leg. Tourniquets work by squeezing large blood vessels. The squeezing helps stop blood loss.

How Do I Put a Tourniquet On?

Tourniquets can be made out of any available material. For example, you can use a bandage, strip of cloth, or even a t-shirt. The material should be at least 2 to 3 inches wide. The material should also overlap itself. Using thin straps or material less than 2 inches wide can rip or cut the skin.

Tourniquets often use a windlass device to increase tightening. Inflated tourniquets (for example, those made from blood pressure cuffs) can work well. But they must be carefully watched for small leaks.

The injured blood vessel is not always right below the skin wound. Place the tourniquet between the injured vessel and the heart, about 2 inches from the closest wound edge. There should be no foreign objects (for example, items in a pocket) beneath the tourniquet. Place the tourniquet over a bone, not at joint.

What Else Do I Need to Know?

All bleeding should stop soon after you tighten the tourniquet. You must place a second tourniquet above the first if bleeding does not stop and you cannot tighten the tourniquet, or if the arm or leg swells above the tourniquet.

Once bleeding is controlled

  • Mark the time on the arm or leg

  • Keep the tourniquet visible

  • Check the arm or leg every 2 hours for

    • Swelling

    • New bleeding

    • Increased muscle stiffness

Do not remove or loosen the tourniquetuntil professional care is available.

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Article Information

Source: King DR, Larentzakis A, Ramly EP; Boston Trauma Collaborative. Tourniquet use at the Boston Marathon bombing: lost in translation. J Trauma Acute Care Surg. 2015;78(3):594-599.

Topic: Trauma

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