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Tourniquet

Clinical Indications:

    Life threatening extremity hemorrhage that can not be controlled by other means. Serious or life threatening extremity hemorrhage and tactical considerations prevent the use of standard hemorrhage control techniques.

Contraindications:

    Non-extremity hemorrhage

    Proximal extremity location where tourniquet application is not practical

Procedure:

    A. Establish a need for a touniqet meeting the above criteria. Advise EMS29
    B. Remove the C-A-T from the trauma bag and carrying pouch.
    C. Open the CAT completely and apply to injured extremity.

    Step 1: Route the self-adhering band around the injured extremity and pass the free-running end of the band through the inside slit of the friction adaptor buckle.

    Step 2: Pass the band through the outside slit of the buckle utilizing the friction adaptor buckle which will lock the band in place.

    Step 3: Position the C-A-T above the wound; leave at least 2 inches of uninjured skin between the C-A-T and the wound.

    Step 4: - Pull the free running end of the Self-Adhering Band tight and securely fasten it back on itself (if applying to an arm wound). Do not adhere the band past the Windlass Clip. - If applying to a leg wound, the Self-Adhering Band must be routed through both sides of the friction adapter buckle and fastened back on itself. This will prevent it from loosening when twisting the Windlass Clip.

    Step 5: Twist the Rod until bright red bleeding has stopped. When the tactical situation permits insure the distal pulse is no longer palpable.

    Step 6: Lock the rod in place with the Windlass ClipTM

    Step 7: Secure the rod with the strap. grasp the Windlass StrapTM, pull it tight, and adhere it to the opposite hook on the Windlass ClipTM

    Step 8: Must note the time applied and communicate it with the receiving facility upon arrival.

    Step 9: Dress wounds as per standard wound care protocol

    Step 10: If for uncontrollable reason tourniquet will be applied for longer than 2 hours attempts should be made to remove the tourniquet after attempts at more aggressive hemorrhage control by loosening tourniquet ½ a turn every 2 minutes.

    The C-A-T Is ready for transport

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure.

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