Updated: Nov 9, 2021
Why We Keep The Tourniquet Ready To Use Stagement and How?
Some commercial tourniquets arrive ready to use like the Rapid Application Tourniquet, while others must be folded or staged and stored for quick launch in an emergency. These tourniquets are life-saving devices, but their effectiveness can be compromised if they are not ready for use when an emergency occurs.
This article takes a critical look on the need to keep the tourniquet ready to use stagement and how to go get started.
What are tourniquets?
It is no secret that a tourniquet is an indispensable part of a trauma kit. They are especially crucial in combat zones and during medical emergencies.
These devices are designed to control arterial and venial blood flow from a severe injury or extremity by producing enough circumferential pressure, preventing blood loss or hemorrhages.
Tourniquets are therefore used to control life-threatening extremities. Contrary to popular belief, tourniquets don’t facilitate amputation but can be used on amputations caused by explosions to save the patient's life.
They are also highly useful when a person is trapped and the affected limb can’t be reached to apply direct pressure.
However, a tourniquet can’t perform any of these functions if a first responder starts unwrapping and prepping the device during an emergency. Also, beyond proper storage, responders must know how to correctly apply the device.
While there are various types of tourniquets, in this entry we will place our focus on the CAT tourniquet. Keep reading to discover how to correctly fold, store and apply a CAT tourniquet.
But first …
Why is it important to fold or stage a tourniquet?
The first and most essential function of a tourniquet is to control extremely heavy bleeding, fast. This means it’s not enough to control the blood flow, it must be done as fast as possible.
For quick deployment during emergency situations, tourniquets must be properly folded and staged before use.
Due to the stress in the heat of such situations, preparing a tourniquet at that moment can be very challenging and as a result, the blood loss won’t be contained.
According to medical experts, when an individual is bleeding profusely from either a major artery or vein, the bleeding is likely to pulsate in time with the heart, resulting in quick blood loss or hemorrhage.
With extremely heavy bleeding an adult could easily lose 40% of their blood volume in 3-4 minutes, while a child can lose the same amount of blood in less time.
If a casualty loses a substantial amount of blood – more than 20% of their blood volume, their body will no longer be able to compensate for that amount of blood loss, which will lead to a hypovolemic shock.
Hypovolemic or hemorrhagic shock is a dangerous and life-threatening condition that occurs when a person loses more than 1/5 of their blood supply. If untreated, it can lead to multiple organ failure and eventually death. But, it can be averted in an emergency situation if the emergency responder or wounded person can apply the tourniquet quickly. Thus, preparing a tourniquet prior to use not only stops severe bleedings but saves lives.
Since it is difficult to determine when a casualty started bleeding, a tourniquet must be applied in 15 seconds to save lives.
Further, military and civilian researches reveal that effective use of tourniquets on severe traumas can reduce the risk of nerve palsies or infections and prevent ischemic limb complications. Simply put, fast application of tourniquets can save limbs too.
More importantly, with properly folded and stored tourniquets one-handed or self -applications become easier and faster. Limited or compromised fine motor skills are common in emergencies making the application of a tourniquet using one hand very difficult, if not impossible if the device is poorly folded.
How To Fold a CAT tourniquet
We will be looking at the two most efficient ways to fold the CAT tourniquet.
Take the tourniquet out of its wrapper, unfasten the strap from the plastic buckle, and follow these steps to fold correctly:
Step 1: Feed the red tip of the strap through the first buckle and pull.
Step 2: Fold the strap back on itself. The further you pull the strap, the smaller the loop. Determine the length to keep this measurement at.
Step 3: Now that you have the desired loop size, place the unfolded area of the strap under the tourniquet to the length of the plastic buckle.
Step 4: Next, fold the remaining part of the strap back upon itself.
Step 5: Lastly, secure the end of the windlass rod in the windlass clip and fold the windlass strap to the side.
If done properly, your tourniquet should appear flat and streamlined.
Step 1: Release the strap completely from the buckle and place the device on its back.
Step 2: Fold the back end of the strap to the top of the plastic buckle and fold it back down on itself.
Step 3: Continue folding in the same manner
Step 4: After the last fold, feed the red tip through the buckle and slightly fold it over.
The tourniquet should appear flat and streamlined if done properly.
This method offers two key advantages. It allows for a wider circumference of the loop for larger limbs and users can easily remove the strap if they need to apply the tourniquet around a leg.
Common Folding Mistakes To Avoid
If you’re using the first method, do not pull the strap until the loop is too tight or too small. This will make the device complex to apply.
Never deploy the windlass or TIME strap over the windlass clip when folding, always ensure that it is secured at the side of the device as it can be challenging to detach the windlass strap from the clip in an emergency setting due to loss of fine motor skills. Also, detaching the strap, securing the windlass rod, and redeploying the strap when applying the tourniquet is time-consuming and might cost your patients their life.
How to use the CAT tourniquet, right.
Perfecting your tourniquet folding skills doesn’t suffice. You must also be able to effectively apply or deploy the device around an injured limb. While the instructions for how to use a tourniquet are pretty simple, you need to know the steps well in advance of injury and review the instructions periodically to refresh your mind.
Here are the steps to follow:
Pull the device apart to unfold the loop
Insert wounded limb through the loop of the strap.
Tighten the strap and fasten it back on itself all the way around the wounded limb, but not over the clips.
Next, twist the rod until the bleeding has stopped and inserted one end into the windlass clip.
Thread the excess strap through the clip and secure using the TIME or windlass strap. Check bleeding conditions. If massive bleeding continues, apply another 2-4 inches CAT tourniquet above the first.
Tip: Always ensure that the device is placed 2-4 inches above the extremity and never on a joint.
Several studies show that tourniquets can save lives both in civilian and active threat environments. In fact, since 2005, when the US Army began using the CAT tourniquet in combat, mortality due to extreme bleeding has dropped by a whopping 85%.
However, it is crucial to note that tourniquets can only save lives if they are applied rapidly and properly.
Hence, the importance of proper folding and staging. Also, there is a need for all emergency responders to be familiar with lifesaving tourniquets and to practice self-application, single-handed, and two-handed application techniques so they can master tourniquet application.
The guides above provide all the crucial steps and details users need to enable them to properly fold and apply the CAT tourniquet.