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Tourniquets
Today the tourniquet is used for a variety of life-saving reasons and is a must piece of emergency equipment for rescue workers, forward deployed military, EMTs, climbers and yes, homeowners. The basic idea of preventing blood flow in one part of the body to save either life or limb goes back to our prehistoric ancestors. During medieval times the idea of the tourniquet underwent a slight revision and became primarily a tool to constrict blood flow in order to facilitate amputations. During the 18th century a French surgeon named Jean Louis Petit invented a modified version of this ancient device and gave it the name ‘tourniquet’. The word is derived from the word ‘turnstile’ due to the turning motion of the windlass.

CAT Tourniquet
There are a few big names in the tourniquet business and Recon Medical is perhaps the biggest. They produce a full line of affordable, easy to use tourniquets like this one that fit easily into your emergency kit and can be deployed in seconds when need be. This Recon Medical Gen 3 Mil-Spec tourniquet features an assisted occlusion strap with finger hole that allows you to bring positive force to bear even in sloppy, challenging conditions. There’s an aluminum windlass, kevlar stitching and a rock-solid buckle that keeps the device in place. There aren’t a lot of changes from the previous iteration of this tourniquet. Basically, it just has a more formidable feel to it. And at this price that’s enough to recommend it.

Tourniquets
There’s an aluminum windlass, kevlar stitching and a rock-solid buckle that keeps the device in place. There aren’t a lot of changes from the previous iteration of this tourniquet. Basically, it just has a more formidable feel to it. And at this price that’s enough to recommend it.

What is a Tourniquet
As we mentioned in the opening the tourniquet has been around in one form or another since prehistoric times. There’s evidence that Stone Age people employed the technique of cutting off blood flow to save lives many thousands of years ago. Although just what they did once they prevented the patient bleeding out remains something of a mystery. Nonetheless, the tourniquet was a well known and (apparently) a widely practiced way to try and save lives. In the 18th century Jean Louis Petit (2), a surgeon working in Paris developed the screw tourniquet. What set it apart from existing tourniquets was its ability to be installed and released by a single individual. Early version of this tourniquet consisted of wooden parts. But later, metal was introduced. There have been various refinements of Petit’s tourniquet, but the basic design has survived and is still employed in emergency situations worldwide.

Are There Any Risks to Using a Tourniquet?
Tourniquets should not be considered a first option. They should be employed only if it is impossible to apply direct pressure to the wound or if the blood flow is so great that extraordinary measures are called for. This is because cutting off blood flow to most of a limb could potentially lead to other serious issues. For this reason the tourniquet should also be removed as soon as it is safe to do so. The potential problems we just mentioned include: Ischemia – Ischemia (6) is the technical term for inadequate blood flow to bodily tissues. This can happen if a tourniquet is left in place for too long. After about 2 hours with a tourniquet in place nerve damage will start to manifest. So will damage to muscle tissue and veins. A couple of more hours and muscle damage will be irreversible. Necrosis, or tissue death, will also set in. As we mentioned above it’s important to remove the tourniquet as soon as it is safe to do so. Compartment syndrome – While many folks have at least some understanding of ischemia virtually no one outside of medical professionals have heard of compartment syndrome (7). But it is a risk when tourniquets are involved. In this case the ‘compartment’ is the limb; either the arm or the leg. Application of a tourniquet can raise the pressure within the limb by trapping blood and other fluids. When this happens it can result in nerve and/or muscle damage. Death by slow release – In an attempt to save a limb some will loosen a tourniquet incrementally over time. While the thought is honorable this incremental exsanguination (8) as it is called often leads to victims slowly bleeding out and dying. Reperfusion – Tissue damage caused by a lack of blood becomes a danger if the tourniquet is in place too long. Conversely, if the tourniquet has been in place long enough that lack of oxygen has caused damage to the muscle tissue reintroducing oxygenated blood – called ‘reperfusion’ (9) – can increase muscle damage rather than relieving it. When it comes to tourniquets the by-word is ‘caution’. Only apply them when absolutely necessary and don’t leave them in place longer than necessary. A tourniquet when used properly can save an arm or a leg or even a life. But when left on too long or improperly applied the above risks come into play.

Tourniquets
The tourniquet has been saving lives for thousands of years. Despite all the medical advances we’ve made as a species this decidedly low-tech device continues to play an important role in triage (10) situations. There are two prime considerations when it comes to the application of tourniquets. One, they should not be used if direct pressure will work. And two, you should never leave one in place longer than necessary. Should you find yourself in a situation where application of a tourniquet is necessary, follow the steps outlined above to be sure you’re installing it properly. Any of the tourniquets on our list will be important additions to an emergency medical kit. Just remember they’re the last option, not the first.