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Use of a tourniquet can stall the life-threatening consequences of a crush related injury and can be a second option if the person cannot immediately have the fluids that were lost be medically replaced back into the body. Tourniquet measures should be taken if the person has been entrapped for more than two hours. [14]
Correct use of tourniquet devices has been shown to save lives under austere conditions with comparatively low risk of injury. In field trials, prompt application of emergency tourniquets before the patient goes into shock are associated with higher survival rates than any other scenario where tourniquets were used later or not at all. [2] [3]
Tourniquet being applied to an arm on a training dummy A combat tourniquet commonly used by combat medics (military environment) and EMS (civilian environment).. A tourniquet is a device that is used to apply pressure to a limb or extremity in order to create ischemia or stopping the flow of blood.
As an enemy is suppressed, casualties can move or be moved to more secure positions. The only medical treatment rendered in CUF is stopping life-threatening hemorrhaging (bleeding). TCCC actively endorses and recommends the early and immediate use of tourniquets to control massive external hemorrhaging of limbs.
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The use of tourniquets and injected anesthesia to induce localized anesthesia was first introduced by August Bier in 1908. He used an Esmarch bandage to exsanguinate the arm and injected procaine between two tourniquets to rapidly induce anesthetic and analgesic effects in the site. [ 3 ]
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Because these nerves supply sensation to the skin of the medial and posterior aspects of the arm and axilla, a tourniquet on the arm may be poorly tolerated in such cases. Subcutaneous injection of local anesthetic over the medial aspect of the arm in the axilla helps patients tolerate an arm tourniquet by blocking these nerves. [13]