Severe Bleeding: Make a tourniquet
People need to learn lifesaving skills in case they are caught up in a serious incident.
It is important how to deal with serious bleeding and if necessary how to make and apply a tourniquet.
This may not be your first action but if DIRECT PRESSURE is failing then this could be a life saving intervention.
(1) Place the tourniquet around the limb, between the wound and the body trunk (or between the wound and the heart). Place the tourniquet 2 to 4 inches from the edge of the wound site. Never place it directly over a wound or fracture or directly on a joint (wrist, elbow, or knee). For wounds just below a joint, place the tourniquet just above and as close to the joint as possible.
(2) The tourniquet should have padding underneath. If possible, place the tourniquet over the smoothed sleeve or trouser leg to prevent the skin from being pinched or twisted. If the tourniquet is long enough, wrap it around the limb several times, keeping the material as flat as possible. Damaging the skin may deprive the surgeon of skin required to cover an amputation. Protection of the skin also reduces pain.
Applying the Tourniquet.
(1) Tie a half-knot. (A half-knot is the same as the first part of tying a shoe lace.)
(2) Place a stick (or similar rigid object) on top of the half-knot.
(3) Tie a full knot over the stick.
(4) Twist the stick until the tourniquet is tight around the limb and/or the bright red bleeding has stopped. In the case of amputation, dark oozing blood may continue for a short time. This is the blood trapped in the area between the wound and tourniquet.
(5) Fasten the tourniquet to the limb by looping the free ends of the tourniquet over the ends of the stick. Then bring the ends around the limb to prevent the stick from loosening. Tie them together under the limb.
NOTE: Other methods of securing the stick may be used as long as the stick does not unwind and no further injury results. NOTE: If possible, save and transport any severed (amputated) limbs or body parts with (but out of sight of) the casualty.
(6) DO NOT cover the tourniquet--you should leave it in full view. If the limb is missing (total amputation), apply a dressing to the stump.
(7) Mark the casualty's forehead, if possible, with a "T" to indicate a tourniquet has been applied. If necessary, use the casualty's blood to make this mark.
(8) Check and treat for shock.