Updated Guidelines on Tourniquet Application by the Faculty Of Pre-hospital Care

In July 2017, the Faculty Of Pre-hospital Care at the Royal College of Surgeons Of Edinburgh released updated recommendations for tourniquet application in emergency settings, emphasizing limb salvage and reduced tissue damage.

New Recommendations for Tourniquet Placement

The latest guidelines advise placing tourniquets as distally as possible above the wound on limbs, avoiding direct placement on the wound or joints. This change aims to minimize tissue damage while improving the chances of limb salvage.

Application and Adjustment

• Direct Skin Application: Tourniquets should be applied directly to the skin and tightened sufficiently to halt arterial bleeding.
• Use of Multiple Tourniquets: If bleeding persists, a second tourniquet may be applied above the first to effectively stop the haemorrhage.

Correct Usage Is Crucial

Incorrect application of tourniquets can exacerbate injuries. It's vital that tourniquets are used properly, ensuring they are tight enough to stop arterial, not just venous, bleeding.

Special Considerations

In situations where a limb is trapped, tourniquets can initially be applied proximally up the limb. Once the limb is freed, re-evaluate and apply another tourniquet closer to the wound if necessary, then remove the proximal one.

Maintaining Tourniquet Placement

Tourniquets should remain in place until advanced medical care is available to ensure the best possible outcome for the patient.