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Tip of the Week — An NREMT Review of Tourniquet Application
The NREMT updated both the ALS and BLS skills stations this year with the major change being the alteration of the “Bleeding Control and Shock Management Station.” Previously, EMTs and paramedic students were required to first apply direct pressure, elevate the injured area, utilize arterial pressure points and then after all of those interventions failed, apply a tourniquet.
New evidence collected in recent years from the battlefields of Iraq and Afghanistan have proven the effectiveness and safety of applying tourniquets earlier in the process. Now, the NREMT is testing EMTs and Paramedics to first apply direct pressure and if the bleeding doesn’t stop, to move directly to application of the tourniquet.
Previously, the fear of using a tourniquet centered around the thought that using a tourniquet on an extremity meant that the limb was lost and an amputation was certain simply because of the tourniquet application. That is now understood not to be the case.
The muscle and bone tissues of the extremities may be revived as long as 5 to 6 hours later. Since few if any EMS agencies in the U.S. have a normal transport time greater than 5 hours, the tourniquet becomes a more appropriate action to take.
Review your tourniquet rules using your own protocols along with the reference articles I have included below for all EMT and Paramedic personnel whether they are students or veteran providers.
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