Here are the points to remember about using a
1. Use a tourniquet only as a last resort! Dont
use a tourniquet unless you cant control the
bleeding by any other means.
2. Dont use a tourniquet for bleeding from the
head, face, neck, or trunk. Use it only on the
3. Always apply a tourniquet above the wound
and as close to the wound as possible. As a
general rule, do not place a tourniquet below the
knee or elbow except for complete amputations.
In certain distal areas of the extremities, nerves
lie close to the skin and may be damaged by the
Furthermore, rarely does one
encounter bleeding distal to the knee or elbow
that requires a tourniquet.
4. Be sure you draw the tourniquet tight enough to
stop the bleeding, but dont make it any tighter
than necessary. The pulse beyond the tourniquet
5. Dont loosen a tourniquet after it has been
Transport the victim to a medical
facility that can offer proper care.
6. Dont cover a tourniquet with a dressing. If it is
necessary to cover the injured person in some
way, make sure that all the other people
concerned with the case know about the
tourniquet. Using crayon, skin pencil, or blood,
mark a large T and the time the tourniquet was
applied on the victims forehead or on a medical
tag attached to the wrist.
MANAGEMENT OF INTERNAL
Internal soft-tissue injuries may result from deep
wounds, blunt trauma, blast exposure, crushing
accidents, bone fracture, poison, or sickness. They
may range in seriousness from a simple contusion to
life-threatening hemorrhage and shock.
Visible indications of internal soft-tissue injury
include the following:
Hematemesis (vomiting bright red blood)
Hemoptysis (coughing up bright red blood)
Melena (excretion of tarry black stools)
Hematochezia (excretion of bright red blood
from the rectum)
Hematuria (passing of blood in the urine)
Nonmenstrual (vaginal bleeding)
Pooling of the blood near the skin surface
More often than not, however, there will be no
visible signs of injury, and the Corpsman will have to
infer the probability of internal soft-tissue injury from
other symptoms such as the following:
Pale, moist, clammy skin
Rapid, feeble pulse
Falling blood pressure
Dilated, slowly reacting pupils with impaired
Dehydration and thirst
Yawning and air hunger
Anxiety, with a feeling of impending doom
Figure 4-28.Applying a tourniquet.