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Tourniquets
Immediate Treatment

Hospital Corpsman Revised Edition - Complete Navy Nursing manual for hospital training purposes
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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.







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