New look at tourniquets

Hmmm. Could we generalize and say TK's on arterial bleeding unstopped in five minutes by pressure (or jump to TK if the spurter is above the knee or elbow)?

I think we should base it on 3 factors:

The type of wound. Such as a longutudinally cut artery seen in avulsion type wounds blunt or penetrating. Similar to IEDs and person vs automated equipment in a crushing and tearing scenario, where the is no amputation but would be easier.

As you mentioned where the artery is retracked, but that may be a really tough call, particularly proximal to the elbow and knee as it may retract into the chest, neck, or pelvis, giving the impression of controlling bleeding, but really just relocating it. Tough call, but I would most likely use the Tq in that instance myself.

Finally where direct pressure is not effective. I wouldn't classify it by time but by effort, if you have several stacked gause pads and are leaning all our weight on a bleed and it is still seeping through your fingers, it may be time for the tq.

I do not think pressure points were ever field practical (though a temporary in house method may work) and on a serious bleed elevation was just a form of hazing on the FNGs during registry.

I am also not a big fan of the chemical bandages based on what I have read, but I have never used one, but that is another thread.
 
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