Here are the points to remember about using a
tourniquet:
1. Use a tourniquet only as a last resort! Don’t
use a tourniquet unless you can’t control the
bleeding by any other means.
2. Don’t use a tourniquet for bleeding from the
head, face, neck, or trunk. Use it only on the
limbs.
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
compression.
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 don’t make it any tighter
than necessary. The pulse beyond the tourniquet
should disappear.
5. Don’t loosen a tourniquet after it has been
applied.
Transport the victim to a medical
facility that can offer proper care.
6. Don’t 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 victim’s forehead or on a medical
tag attached to the wrist.
MANAGEMENT OF INTERNAL
SOFT-TISSUE INJURIES
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
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)
Epistaxis (nosebleed)
Pooling of the blood near the skin surface
Other Symptoms
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
Subnormal temperature
Rapid, feeble pulse
Falling blood pressure
Dilated, slowly reacting pupils with impaired
vision
Tinnitus
Syncope
Dehydration and thirst
Yawning and air hunger
Anxiety, with a feeling of impending doom
4-34
Figure 4-28.—Applying a tourniquet.
