Talk:Emergency tourniquet

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Protocols[edit]

"In triage, a person with a tourniquet should be considered "I" for immediate in the START protocol and at least "Yellow" or higher in other protocols." -- in which countries does this apply? Is this an international system or yet another case of US-POV? -- Tarquin 08:56, 24 Aug 2003 (UTC)

The START protocol is a specific triage protocol designed for use by laypersons. It was developed in California but is rapidly being used worldwide, especially in disaster recovery. Most protocols worldwide are meant for use by medical professionals and use colors -- I know that almost all military medicine uses Green, Yellow, Red, Black. However, laypeople are discouraged from using the colors because they don't have the skills to make the determination properly. No US-POV was intended, and I don't see any in this article. clarka 24 Aug 2003

Ok, cool. Do we have a START protocol article? And what is the general term for different protocols? we sould have an overview article with tta name -- Tarquin 09:14, 24 Aug 2003 (UTC)

Um, triage? clarka 2 Mar 2004

Rubber ?[edit]

Added "Pressure bandage" reference. The "risks" statement states that several hours of tourniquet use may require amputation. In all actuality only fifteen minutes could cause extremity death after severe blood loss. Should this be changed and cited? This is a paragraph that may be yielding information to an immediate user. —Preceding unsigned comment added by 75.94.60.115 (talk) 18:01, 18 October 2009 (UTC)[reply]

Hello,

I wonder about "a piece of rubber tubing is wrapped around the limb". First of all, a non-elastic strap works well, and it is easier to find a non-elastic strap (e.g. a necktie, a scarf, a belt) than a rubber tubbing (I never have one with me). In France, we even teach that to use a strap that is not elastic, because an elastic strap could enhance the vein bleeding (such method is used to make the veins "bigger" when preparing an IV).

Any opinion ?

Cdang 12:49, 26 Aug 2004 (UTC)

I welcome your perspective and have integrated it into the article. Prehospital providers approach the use of the tourniquet in the United States with fear and trembling; we have had a long history of needless use and resulting lawsuits. When this is combined with the common availability of reattachment surgery here, and the fact that a tourniquet pretty much wrecks any hope of surgical reattachment, the U.S. medical and first aid community really don't like them, even when done by prehospital professionals such as paramedics (minimum 2,000 hours clinical training). Emergency physicians and surgeons are much more likely to whip out the hemostat(s) and/or sutures, which are also taught to battlefield medical personnel.

On the other hand, Wikipedia is for worldwide use and the tourniquet has saved many thousands of lives, and will no doubt go on saving lives. However, outside of the developed countries, a tourniquet WILL inevitably result to amputation later. So I have tried to strike a balance between "Don't do this!" and "If you really MUST do this, here is the best way how."

clarka 28 Sept 2004

Suggestions[edit]

To be NPOV on this disputed issue we must identify the fact that there is disagreement and present the arguments of both sides. Presently there are no references at all in the article. Each argument must be referenced - there must be a source for each idea presented. The way the contents are laid out, with a major section "Risks of a tourniquet" and then four particular jurisdictions as sub-headings, makes little sense. It's not clear why tourniquets have different risks in different areas. Risks should be clearly identified as physical risks to the patient -- which don't depend on the jurisdiction except in the level of advanced surgery expected there; and legal risks to the person using a tourniquet -- which obviously do depend on the jurisdiction. The actual text in each sub-section is not just talking about the risks of a tourniquet in that area, but rather the reasons why tourniquets are used or not used, and encouraged or not encouraged, in that area. The article often talks about specific practises without indicating where in the world these practises are common. It also often speaks in a tone of instruction instead of a tone of description. For example, "If a tourniquet is used, immediately mark the letter "T" on the victim's forehead with the victim's blood, a marker, pen, or dirt" -- this is clearly bad style. It doesn't say where such a practise is common, or under what system such a practise is mandated. ralmin 19:01, 24 January 2007 (UTC)[reply]

Limited Information[edit]

The information on this article is quite limited and does not even cover the topic of pneumatic tourniquets. Pneumatic tourniquets are very common in the surgical environment as they allow for precision pressure control. There is also no discussion of Limb Occlusion Pressure (LOP) which is defined as the minimum tourniquet pressure required to occlude the operative limb. It has been well established in the tourniquet literature that lower tourniquet pressures are safer.

I intend on expanding this article in the near future with the work of J.A. McEwen, Ph.D., P.Eng., but in the mean time I've included an external link to http://www.tourniquets.org so that users may be able to get up to date information on tourniquets and tourniquet usage.

Michael Gebert —The preceding unsigned comment was added by Mgebert (talk • contribs) 22:16, 19 March 2007 (UTC).[reply]

My colleague Graham Noble will also be making changes to this article and any related articles. Please feel free to discuss these changes as they appear.

--Mgebert 23:12, 22 March 2007 (UTC)[reply]

This article currently addresses emergency tourniquets. Surgical tourniquets are a very common but different type of tourniquet. I propose to move the current tourniquet article to one titled "emergency tourniquet", to add an article on "surgical tourniquets", and to make "tourniquet" a disambiguation page to help differentiate between the two. --Gnoble 21:41, 29 March 2007 (UTC)[reply]

Design[edit]

This page is devoid of the simple and obvious description of what a tourniquet is - it's design and construction. These seem to me more substantive to tourniquets than the (also important) differences in tourniquet philosophy in various nations. 68.34.11.192 (talk) 13:19, 2 July 2008 (UTC)[reply]

Outdated Information[edit]

Much of the information on tourniquets is out of date. For example the national curriculum for EMTs in the United States has tourniquets as the second step after direct pressure for controlling bleeding. The trend is focused on bleeding being worse than any erosible limb damage. — Preceding unsigned comment added by 216.222.139.71 (talk) 07:02, 9 June 2011 (UTC)[reply]

Overhaul Proposal[edit]

Looks like it's been a while since this article received any TLC. It's full of out-dated information and unsourced myths about tourniquet use. I've started a rewrite using academic journals, and you can track my progress at the sandbox. Would appreciate input from fellow editors. — Preceding unsigned comment added by Wafflephile (talk • contribs) 18:55, 25 October 2011 (UTC)[reply]

I'm essentially proposing a complete rewrite, and I'd love to have input regarding the version in my sandbox. All unsourced and out-dated info has been removed, and I've replaced them with sections on established risks, safety measures, design considerations, and future development. It's a work in progress, to say the least. Wafflephile (talk) 22:11, 28 October 2011 (UTC)[reply]
OUTSTANDING!!! This was an amazing improvement! --Gene Hobbs (talk) 00:31, 6 January 2012 (UTC)[reply]
Thank you! And many more thanks for adding those refs back; I didn't have access to them and thus could not verify the content. Wafflephile (talk) 16:47, 6 January 2012 (UTC)[reply]

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