With more and more South Africans are being exposed to trauma on a daily basis, as bystanders or witnesses, we are often the first people on the scene, especially Motor Vehicle Collisions (MVC). The quick initial point of wound care and treatment of potentially life-threatening injuries by bystanders can save many lives.
Therefore controlling massive extremity bleeding is the first priority in saving trauma patients and avoiding unnecessary deaths. Tourniquets work best when they are applied as early as possible at the point of injury.
What Is a Tourniquet?
A tourniquet is a device that is placed around a bleeding arm or leg. Tourniquets work by imposing circumferential pressure on a limb, thus squeezing down and blocking blood vessels. The squeezing helps stop blood loss. Commercial or Improvised tourniquets can be used, with the Combat Application Tourniquet being the most popular and easiest to use. A systematic review revealed TQ to be an effective tool for the management of extremity haemorrhages in civilian trauma, associated with few complications. Larger studies and dedicated training courses are needed to improve the use of TQ in the civilian standards of care.
The ideal person to apply a tourniquet is the person who can do it the quickest immediately after the wound is identified
A March 2018 study found victims of blood loss who did not receive a tourniquet had almost six times greater odds of death.
The C-A-T tourniquet for Bleeding Control
“The patented Combat Application Tourniquet® (C-A-T®) featuring the proprietary red tip design and the mechanical advantage of a band within a band has been the Official Tourniquet of the U.S. Army since 2005.”
The Combat Application Tourniquet (CAT) is an effective tool to help control severe blood loss from the body's extremities. If used correctly, the CAT has the proven ability to save lives. A general misconception a tourniquet is that it will result in the casualty requiring amputation of their extremity; this is false. Amputation is more often required as a result of the injury itself, not because of the tourniquet.
Parts of C-A-T tourniquet
Application of a C.A.T. Tourniquet
Step 1
Insert the wounded extremity (arm or leg) through the C.A.T.
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Step 2
Pull the self-adhering band tight, and securely fasten it back on itself.
Be Sure to Remove All Slack.
Step 3
Adhere the band around the extremity. Do not adhere the band past the clip
Step 4
Twist the windlass rod until the bleeding has stopped
Step 5
Lock the windlass rod in place in the windlass clip. Bleeding is now controlled
Step 6
Adhere the remaining self-adhering band over the rod, through the windlass clip, and continue around the extremity as far as it will go
Step 7
Secure the rod and the band with the windlass strap.
Grasp the strap, pull it tight, and adhere it to the opposite hook on the windlass clip.
Note the time the tourniquet was applied.
Points to Remember:
- The CAT should be a LAST RESORT for blood control management. Applying direct pressure to the injury and elevating the extremity above the heart should be attempted prior to utilizing the CAT.
- Training is a very important element of proper use, and placement of the CAT tourniquet and should not be overlooked.
Also View
Burns and Treatment of Burns
Treatment of and Response to Cuts and Bruises