# Help! What are the current CA EMS protocols regarding tourniquet use?



## Hotshot007 (Nov 20, 2010)

Hey all, I desperately need a hand figuring out the proper protocol regarding use of a tourniquet in the field, as it is much diffetrent than from when I first certified. I am recertifying for EMT-B after my cert lapsed in March. I wasn;t actively using it in a heath care setting (construction labor risk assessment contracting instead), so I couldn;t roll over my work experience as a recertifying factor, so I have to go thru the paperwork all over again.

Unfortunately, when I was first certified 3 years ago, all paperwork and a lot of local protocols was done thru local agencies instead of the state wide stuff, and some of the local agencies in my area had differing protocols about tourniquet use. I was taught 3 years ago to use it only as a VERY last resort or in case of an obvious extremity amputation. Then when I went and recertified for my skills tests, I was told that they changed again and tourniquets were in again. So I am asking, what is the CA state protocol regarding the use of tourniquets? And if so, is it specific to the local protocols or have they finally mandated state-wide standard protocols as well? Tried getting it off the CA EMS Board website, but that;s like sifting thru a dump of new, possibly old and definitely outdated data and regulations for what I need....


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## Shishkabob (Nov 20, 2010)

If direct pressure doesn't stop serious bleeding, throw on a tq.


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## JPINFV (Nov 20, 2010)

Hotshot007 said:


> Unfortunately, when I was first certified 3 years ago, all paperwork and a lot of local protocols was done thru local agencies instead of the state wide stuff, and some of the local agencies in my area had differing protocols about tourniquet use.


Treatment protocols are still done through your LEMSA, so what county are you in?


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## Hotshot007 (Nov 21, 2010)

Currently located in LA County, although may be moving to Ventura or Santa Barbara county soon for family reasons


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## RUGBY66X (Nov 21, 2010)

national registry also changed it from pressure,pressure, dressing, elevate, pressure point then tourniquet to it now being just pressure than if that fails use a tourniquet.


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## Markhk (Nov 22, 2010)

In July, the California EMS Authority published their position statement on local scope of practice regarding the use of tourniquets. Their position is that the use of tourniquets are appropriate by all levels of EMS providers, however, they must be authorized by local protocols. 

http://www.emsa.ca.gov/personnel/Local_Scope/Position_Statements/files/Tourniquet (July 2010).pdf

Tourniquet use is not specifically outlined in the scope of practice for EMTs under Title 22 except for the statement EMTs can ,"Provide initial prehospital emergency care of trauma".

Most EMS agencies I've come across in California do not specifically highlight the use of tourniquets in their protocols. (The EMS agency I'm affiliated with even makes a point to say, "Tourniquets NOT indicated" for their trauma/ amputation protocol) This may change with the publication of this position statement document, but expect confusion in the interim.


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## Markhk (Nov 22, 2010)

Also, you might find the current NREMT sheet on bleeding control helpful: 

http://www.nremt.org/nremt/downloads/bleedingcontrolshock.pdf


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