One (potentially) big exception to the doing something is better than doing nothing rule, is applying a tourniquet. I have heard in my wilderness safety class that if you apply a tourniquet to a limb, it will probably need to be amputated, and this should only be done if you’re confident it’s necessary. Applying pressure to a wound that you’re bleeding from should always be the first thing you try.
I added the “potentially” above, because I’m having trouble verifying that claim online. The Mayo Clinic says “Having a tourniquet in place for two or fewer hours — the time in which most patients can get to a hospital — should not have any ill effects beyond those caused by the injury requiring the tourniquet. It typically takes at least 4 to 6 hours for tourniquets to cause harm.”[1] I think this may be the difference between advice for wilderness training, where you are often >4 hours from a hospital, and first aid training for incidents that may happen in everyday life. Of course, the farther you are from a hospital, the greater the risk of actually bleeding out, and it’s better to lose a limb than one’s life, so I think you just need to be careful to weigh the risks.
FWIW, most people without training will not apply a improvised tourniquet correctly anyway, so it probably won’t make much of a difference either way, but I thought this knowledge was worth sharing.
My understanding is that the anti-tourniquet meme is outdated, and the emergency medical response advice now is that the benefits of potentially preventing someone’s death from blood loss outweigh the risk of amputation. I recall being taught in my college course in 2015 that it’s fine to put on a tourniquet, just mark it with the time. And a few years ago, when my mom pulled a heavily bleeding man out of the cab of his overturned truck and wouldn’t let any of the other truckers apply a tourniquet to his arm because she’d been taught that you should never apply a tourniquet, the nurse who showed up at the scene later (and applied a tourniquet) told her it would have been fine to do so. (Yes my mom is a way better person to go to in an emergency than I am, guess it’s not hereditary.)
And I mean yeah, most people aren’t going to successfully tourniquet anything even if they try so ¯\_(ツ)_/¯ But I still think it might be anti-helpful to propagate the ‘don’t apply tourniquets’ meme.
Thanks. This is helpful context. The class I took was only a year ago, so I don’t feel like that obviously fits the “this information is just outdated” narrative, but I am genuinely unsure whether it was good advice at this point. On the margin my statement may have been too strong, and I don’t want to suggest that never using a tourniquet is correct, but I do think it’s probably correct for people to know the risks and alternatives before applying one.
Yeah. In the training I took, they said to apply a tourniquet if the bleeding is continuous and more than 6 oz of blood has been lost, in which case the wound is considered life-threatening.
One (potentially) big exception to the doing something is better than doing nothing rule, is applying a tourniquet. I have heard in my wilderness safety class that if you apply a tourniquet to a limb, it will probably need to be amputated, and this should only be done if you’re confident it’s necessary. Applying pressure to a wound that you’re bleeding from should always be the first thing you try.
I added the “potentially” above, because I’m having trouble verifying that claim online. The Mayo Clinic says “Having a tourniquet in place for two or fewer hours — the time in which most patients can get to a hospital — should not have any ill effects beyond those caused by the injury requiring the tourniquet. It typically takes at least 4 to 6 hours for tourniquets to cause harm.”[1] I think this may be the difference between advice for wilderness training, where you are often >4 hours from a hospital, and first aid training for incidents that may happen in everyday life. Of course, the farther you are from a hospital, the greater the risk of actually bleeding out, and it’s better to lose a limb than one’s life, so I think you just need to be careful to weigh the risks.
FWIW, most people without training will not apply a improvised tourniquet correctly anyway, so it probably won’t make much of a difference either way, but I thought this knowledge was worth sharing.
[1] https://www.mayoclinic.org/medical-professionals/trauma/news/the-crucial-role-of-tourniquets-in-trauma-care/mac-20531726
My understanding is that the anti-tourniquet meme is outdated, and the emergency medical response advice now is that the benefits of potentially preventing someone’s death from blood loss outweigh the risk of amputation. I recall being taught in my college course in 2015 that it’s fine to put on a tourniquet, just mark it with the time. And a few years ago, when my mom pulled a heavily bleeding man out of the cab of his overturned truck and wouldn’t let any of the other truckers apply a tourniquet to his arm because she’d been taught that you should never apply a tourniquet, the nurse who showed up at the scene later (and applied a tourniquet) told her it would have been fine to do so. (Yes my mom is a way better person to go to in an emergency than I am, guess it’s not hereditary.)
And I mean yeah, most people aren’t going to successfully tourniquet anything even if they try so ¯\_(ツ)_/¯ But I still think it might be anti-helpful to propagate the ‘don’t apply tourniquets’ meme.
Thanks. This is helpful context. The class I took was only a year ago, so I don’t feel like that obviously fits the “this information is just outdated” narrative, but I am genuinely unsure whether it was good advice at this point. On the margin my statement may have been too strong, and I don’t want to suggest that never using a tourniquet is correct, but I do think it’s probably correct for people to know the risks and alternatives before applying one.
Yeah. In the training I took, they said to apply a tourniquet if the bleeding is continuous and more than 6 oz of blood has been lost, in which case the wound is considered life-threatening.