Anyone heard of using a BP cuff as a tourniquet?

[lanceavil]

I understand that tourniquets should only be used as a last resort, such as a major arterial bleed or amputation. I heard from one of the medics that it's safer than using a belt or band because the surface area is more spread out and is less likely to injure the patient, and you can inflate it to exactly the point you need it. Agree or disagree?

 

[TransportJockey]

I understand that tourniquets should only be used as a last resort, such as a major arterial bleed or amputation. I heard from one of the medics that it's safer than using a belt or band because the surface area is more spread out and is less likely to injure the patient, and you can inflate it to exactly the point you need it. Agree or disagree?

Disagree on the last resort comment... agree that it can be a useful field expedient tq. But the problem with a lot of cuffs is maintaining that pressure. Some cuffs have pinhole leaks that will slowly let it deflate. Personally I tend to use a triangular bandage, kerlix, and a pen light or pair of trauma shears as a TQ

 

[Mariemt]

They are now being brought back to be used for uncontrolled bleeding, not necessarily just last resort. Yes I've heard of bp cuffs being used but would rather use something else. Like a tourniquet

 

[Wayfaring Man]

The BP cuff can be used as a last resort TK but obviously an actual TK or a field TK with cravats and a yankauer tube are preferred because they're more permanent.

As far as last resort goes, this is no longer the case a lot of places. MD protocol allows us to tourniquet after direct pressure and two attempts to stop bleeding with conventional dressing. With arterial bleeds we can go straight to the TK after direct pressure. The old thinking that a tourniquet would cause possible limb death is no longer really the case with improvements in hospital care. What is important though is to make sure you label the time that the TK was applied clearly and obviously. Guys around here like to write it on the patient's forehead.

 

[EpiEMS]

Nothing wrong with using a BP as a field expedient tourniquet. That's about as far as I'd go with it. Better off using an actual tourniquet (or two, if need be).

 

[JustKeepSwimming]

I volunteer at an ER and a few months ago we had a dialysis patient come in with a burst stent in his arm and the crew that delivered him used a bp cuff as the tourniquet. Doc replaced it with a rubber band tie but the cuff worked and it was a good 2 hr drive from the hospital he was originally at.

 

[MMiz]

I'm not sure why everyone says that they're only used as a last resort. I used one to stop bleeding when I had impaled my hand and blood was gushing everywhere.

Applying pressure to pressure points was in my EMT curriculum as a means of controlling bleeding.

The only mistake I made (per the MD) was that I didn't inflate the BP cuff enough. He suggested I inflate it to 200 mmHg or higher in the future.

 

[NJEMT95]

To avoid leaks, I've heard EMTs suggest tying the BP cuff tubes when using it as a TQ.

 

[firecoins]

Not everyone says that. Those who are preaching the old doctrine. Tourniquets are back in.

 

[Mariemt]

Not everyone says that. Those who are preaching the old doctrine. Tourniquets are back in.

Yep, only time I have tried to avoid one was bleeding from an A/V fistula as I didn't want to damage it.

Once it is on, you have to make sure you document exact time it was put on. Some people even write on the limb above it to make sure paperwork isn't lost while transferring care

 

[patzyboi]

I had a question about this on the NREMT; never even heard of the idea before.

dunno if I ever got the answer right though. lol

 

[DrParasite]

I have seen a doctor use something similar to a BP cuff in the ER to apply direct pressure to a dialysis shunt that was bleeding uncontrollably.

I have seen a BP cuff used as a tourniquet, but most of the time a tourniquet is used instead.

It is a good temporary device, but there are better devices to have permanent blood flow (permanent meaning until you get to the ER , without the cuff deflating while you are in transit).

 

[Christopher]

I understand that tourniquets should only be used as a last resort, such as a major arterial bleed or amputation.

Please use tourniquets early and often (like voting). They're not a last resort (at least not in the last 10 years).

I heard from one of the medics that it's safer than using a belt or band because the surface area is more spread out and is less likely to injure the patient, and you can inflate it to exactly the point you need it. Agree or disagree?

Yes the wider the surface area the better.

I would caution with BP cuffs that the following does not happen:
- Getting blood on the bulb and release screw

If this does...man is it ever hard to undo.

 

[EpiEMS]

I have seen a doctor use something similar to a BP cuff in the ER to apply direct pressure to a dialysis shunt that was bleeding uncontrollably.

I have seen a BP cuff used as a tourniquet, but most of the time a tourniquet is used instead.

It is a good temporary device, but there are better devices to have permanent blood flow (permanent meaning until you get to the ER , without the cuff deflating while you are in transit).

Might be this one: the SAM Junctional Tourniquet

 

[Brandon O]

To avoid leaks, I've heard EMTs suggest tying the BP cuff tubes when using it as a TQ.

Inflate until bleeding is controlled, tie off both tubes, note pressure.

 

[VFlutter]

Might be this one: the SAM Junctional Tourniquet

Looks like a Femostop. We frequently use them in the Cath lab. It is a decent device but I still prefer good old manual compression to obtain homeostasis. It is also limited by body size and anatomy.

Or Anesthesia will use a pneumatic tourniquet for regional blocks, also know as a Bier block. It is connected to a pump that constantly adjusts pressure.

 

[EpiEMS]

Looks like a Femostop. We frequently use them in the Cath lab. It is a decent device but I still prefer good old manual compression to obtain homeostasis. It is also limited by body size and anatomy.

Yeah, the latter part is concerning...I wonder if the military style tourniquets are large enough for the largest sorts of patients. Haven't tried one on anybody much bigger than myself.

 

[CritterNurse]

I'd be more likely to use a BP cuff to pad the lumbar region when someone needs to be boarded. Using a BP cuff as a tourniquets is a good way to make a BP cuff wear out faster. Besides, things like a cravat, a shirt, a belt, etc make better tourniquets in a pinch.

 

[DPM]

I'd be more likely to use a BP cuff to pad the lumbar region when someone needs to be boarded. Using a BP cuff as a tourniquets is a good way to make a BP cuff wear out faster. Besides, things like a cravat, a shirt, a belt, etc make better tourniquets in a pinch.

How do you tighten a shirt?

The CAT tourniquets that the military uses (not to be confused with the Metal SOF one that's a more expensive knock off) are pretty big. I've used them a bunch and never had any size issues... but then again most soldiers aren't obese. If I can find one I'll try and measure it.

 

[TransportJockey]

How do you tighten a shirt?

The CAT tourniquets that the military uses (not to be confused with the Metal SOF one that's a more expensive knock off) are pretty big. I've used them a bunch and never had any size issues... but then again most soldiers aren't obese. If I can find one I'll try and measure it.

You tie a windlass knot and tighten it that way