How do you tie a tourniquet step by step?

As a nurse, you’ll be placing tourniquets on patient’s arms for tasks such as drawing blood, inserting IVs, and more. Therefore, it’s important to learn how to  put on a tourniquet properly.

The best method to start a tourniquet is to use the simple rubber tourniquet band provided in the IV gauge kit or blood drawing kit. These bands are very lightweight and flexible, and they allow you to make a simple but effective compression on a patient’s arm without actually tying a knot. Instead, all you have to do is loop it around snugly, cross the bands, and then form a simple loop. This allows you to remove the tourniquet quickly and easily once you’ve finished your procedure.

At first it may be a little intimidating, but with a little practice, you’ll be able to apply and remove one with ease.

How to Put a Tourniquet on Your Patient

First, I always like to let the patient know what I’m doing. So I usually tell them that I’m placing the tourniquet on their arm to assist with whatever procedure I’m doing. I then take the tourniquet band and stretch it out behind their arm. Make sure to get a good stretch, as this will help compress their arm.

Next, loop the tourniquet around their arm, and cross the two ends as if you were going to tie your shoe laces. Next, take one end loop it around the area under the crisscross you made. Lower the tourniquet so that it tightens on top of this loop.

Notice how you don’t actually tie a knot. Instead, you simply loop it around and let the friction of the rubber hold it in place.

It’s also a good idea to ask the patient if the band feels too tight. You want it tight enough to compress the arm, but you don’t want it to be unnecessarily uncomfortable for the patient.

Here is a video presentation of the procedure:

Remember, all skills take time to master. The key is to practice as often as you can until you get it down.

If you need to use a tourniquet chances are you’re in an emergency situation and every second counts. You’ve exhausted all options, because when it comes to tourniquets, they are not the best option to stop bleeding but it will suffice when needed. Make sure you’re prepared and read about the correct method on how to use a tourniquet.

What is a Tourniquet?

A tourniquet is a tight band used to control bleeding by completely cutting off the blood flow of a wound. A tourniquet is a last resort, as it can cause irreparable tissue damage due to its extreme measures, remember you are trying to cut off blood flow, but if there is absolutely no other way to stop the bleeding, it can be an effective way to do so. If you have tried elevating the wound or if applying pressure is not an option or isn’t working, a tourniquet is the best solution.

How to Create a Tourniquet

Step by Step Guide on How to Apply a Tourniquet

1. First, make sure you have full access to the wound. If it’s covered by clothing, remove the clothing. This will help you assess what is going on with the individual’s body. You will be able to see if blood is squirting rapidly or oozing slowly.
2. You will have to position and tie the tourniquet above the wound. You have to tie the tourniquet around the injured limb several inches above the wound, in order to tie the part that is closest to the heart. If the wound is below a joint, you will need to tie the tourniquet right above the joint.
3. Place the stick or rod on the knot, and tie the loose ends around it to make another knot. Twist the stick or rod to tighten the knot and increase the pressure on the wound. The bleeding should stop after this. Secure the rod or stick by tying it to the individual’s limb. Write the time the tourniquet was placed, to help the paramedics assess how to proceed.

Tourniquets should only be used on limbs and never anywhere else. Do not try using it on the neck, stomach, or back. Call 911 if a voluntary trip to the emergency room is not possible. Make sure that the individual is still breathing.

Taking Care of a Person After a Tourniquet Has Been Placed

You’ve done all the right things. You learned how to use a tourniquet, you’ve applied the tourniquet, you’ve called 911, and now you have to wait. This can be nerve-racking and seem endless. Here’s how to make sure that the person you are caring for makes it to the emergency room:

Check for symptoms of shock:

• Cold, pale, & clammy skin
• Blue tint to the skin
• Faintness
• Confused
• Shallow breathing
• He or she has lost consciousness

To alleviate these symptoms, lay the individual flat on his or her back. Provide them warmth in the form of blankets or body heat.

Where You Can Go To Seek Medical Attention

If you need immediate attention, call 911. Every second counts.

Stop at any of our 3 locations if you need to be treated for a deep wound. It is our sole duty to aid you in high risk situations. Our River Oaks emergency room, Katy emergency room, and Clear Creek emergency room are ready to assist you at a moment’s notice. At Village Emergency Centers, we strive to provide you and your loved ones quality medical emergency care.

Our emergency centers are conveniently open 24/7 and accept walk-ins because we know emergencies are not events that can be planned. Get directions here to visit one of our locations.

Creating and applying a tourniquet is a relatively simple technique that can help control blood loss following a traumatic injury. Used for wounds occurring on the limbs, the device compresses the area around the injury to limit blood flow until the wound can be treated and closed.

“Tourniquets can be used on many injuries that involve profuse bleeding and can be made with almost anything that uses circumferential pressure above the site of bleeding,” Dr. Scott Scherr said.

While tourniquets should only be used during serious medical emergencies, understanding how and why to apply a tourniquet to a wound can be a lifesaving measure.

When and when not to use a tourniquet

A tourniquet can be an effective tool to help stop bleeding, but when used incorrectly, it can cause serious complications and further injury. Because tourniquets severely restrict blood circulation to the area, improper application of the device can cause permanent nerve and tissue damage. In some cases, this can even lead to amputation of the limb.

Tourniquets should be used when the bleeding cannot be stopped by the use of direct pressure alone, or if direct pressure cannot be effectively applied for any reason.

Heavy and uncontrolled bleeding can cause death within minutes, so it’s necessary to act quickly when dealing with a traumatic wound. “Tourniquets should be applied immediately when there is evidence of rapid blood loss,” Scherr said. If the wound continues to bleed heavily under direct pressure, it may require a tourniquet.

Tourniquets should only be applied to treat limb injuries

“You cannot use a tourniquet on the torso or neck,” Scherr said. For wounds that aren’t located on the limbs, even and direct pressure is your best bet.

Do not apply a tourniquet to the joint

Depending on the location of the wound and its proximity to the joint, it may need to be placed just above the joint.

What to use

Many materials can be effective, and when improvising, clothing often is used. “Belts can be a good tourniquet,” Scherr said. “You can also tear a piece of clothing to approximately three inches wide.”

Shirt sleeves, pant legs, scarves and bandanas are all potential options. Whatever you use, be sure it’s wide and thick enough to prevent injury to the limb. It should be two to four inches wide to evenly distribute the pressure around the limb.

You can purchase tourniquet devices to keep in your first-aid kit.

What not to use

Scherr warns that thin material, such as wires or shoelaces, should not be used.

How to apply it

Wrap the material around the limb with an even circumference of pressure. The material should sit as flatly as possible against the skin to prevent neurovascular damage. If you have enough material, wrap it a few times to create padding.

When using fabric, knot a stick or other rigid object, like a pen, on the outside layer of the tourniquet to create a torsion device. Twist the stick to tighten the hold. Continue to twist until tight enough, and knot it again to keep it in place.

If possible, it’s important to keep direct pressure on the wound even after applying a tourniquet. Then immobilize the injured area and call 911 immediately, Scherr said.

Can you apply it on yourself?

Yes, if that’s your only option. “If the injury is on your arm, use your mouth/teeth to help secure the material,” Scherr said.

How tight should it be?

“Tight enough to stop the bright red bleeding. You may see dark red blood oozing, which is OK,” Scherr said. It should feel uncomfortably tight, but not tight enough to cause any paramount pain.

How long can you leave it on?

A tourniquet should only be used in an emergency until you’re able to receive immediate medical attention. “It can be applied for approximately two hours before neurovascular injury occurs,” Scherr said.

Do not remove a tourniquet yourself. A medical professional should do it for you.