Alina Fassbinder Written at 5 September 2023

10 mistakes to avoid when using a Tourniquet - the complete WERO Guide

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If mistakes are made when applying a tourniquet, this can have serious consequences, as the desired effect may not be achieved. Below we explain the ten most common mistakes made when applying a tourniquet and give you tips on how to avoid them.

1. Error: waiting too long before applying the tourniquet

In the case of critical limb haemorrhage, the elapsed time is directly related to the blood loss. If a tourniquet is only applied after all other haemostasis options have been exhausted, too much time may already have elapsed. It therefore makes more sense to use quickly if a serious injury with heavy bleeding is detected. This is the case, for example, in car accidents, industrial accidents, gunshot wounds or deep cuts to the arms or legs.

2. Mistake: Use of improvised tourniquets

The use of unsuitable aids instead of professional products is also a typical mistake. In most cases, aids such as a belt, scarf or item of clothing do not provide sufficient compression. This even applies if a gag is also used. The problem here is usually that unsuitable toggles such as pins or branches are used , which can break quickly or the improvised toggle is not properly secured so that it comes loose again. The use of improvised tourniquets should therefore only be used in extreme emergencies and only if you have mastered the technique of an improvised tourniquet. Accordingly, the following applies: No emergency kit should be without a tourniquet!

250302-0003-Combat-Application-Tourniquet-Anleitungnwoum7mi09W2u_800x800

Combat Application Tourniquet® (CAT®) - Blue

Basic colour: Blue

WERO is the exclusive importer for Germany and Austrian }}n }}n }}n }}CAT® Tourniquet: Quality that counts - the original!n }}n }}The Combat Application Tourniquet® or simply CAT® is a one-hand tourniquet system for rapid haemostasis in the event of life-threatening bleeding from the extremities. n }}n }}What are the advantages of a CAT® Tourniquet? n }}n }}An individually adjustable strap allows the tourniquet to be applied to most extremitiesA robust, ergonomic toggle facilitates gripping and turning n }}n }}The wind system (strap with toggle) tensions a freely movable inner strap to prevent the flow of arterial blood into the extremity n }}n }}Only one handle is required to secure the toggle under a clamping hook n }}n }}During transport, the CAT® 's Velcro fastener provides additional security n }}n }}n }}n }}How do I use a tourniquet?n }}n }} The CAT® tourniquet is an essential component of tactical casualty care. It is used during major incidents, such as terrorist attacks, and as the first measure in the event of life-threatening haemorrhaging. The use of a tourniquet should be trained, but the following applies: in an absolute emergency and if all other rescue measures, such as a tourniquet, are unsuccessful, anyone can use a tourniquet. n }}n }}The tourniquet can also be applied with one hand in an emergency. n }}n }}1. Unfold the CAT® so that the strap forms an O-shaped loop. Then apply the CAT® above the haemorrhage in the direction of the torso. To do this, pass the injured limb through the O-shaped loop of the Velcro strap. n }}n }}2. Tighten the strap so that no more than two fingertips can fit between the tourniquet and the limb. Then firmly connect the Velcro surfaces together. n }}n }}3. Now turn the gag until the bleeding stops and the pulse can no longer be felt below the wound site. n }}n }}4. Secure the gag under the clamping hook. Check the bleeding and pulse again - if necessary, increase the pressure by turning the gag further. n }}n }}5. Now place the end of the strap over the toggle and clamp hook and secure both with the safety Velcro. Then, if possible, make a note of the time of attachment. n }}n }}How can I recognise a fake?n }}n }}There are many copies of this tourniquet. They may not be able to build up the necessary pressure, become loose or tear. Do not jeopardise the life you are trying to save again. Please make sure you get the original from a reliable source. n }}n }}Visually, the differences between genuine and counterfeit tourniquets can be slight and are often difficult to recognise. In some cases, however, the following clues can be used to identify a replica:n }}n }}Red tip outside the USA n }}n }}No or inferior instructions for use: These are often not available in German and do not show the most important data and details of a medical device, such as the manufacturer, EC-REP or importer. n }}Qualitative defects in counterfeits are characterised by the following features, for example:Inferior rods that are bendable and break easily under the required pressure n }}n }}A more extensive winding can make it difficult or even impossible to tighten sufficiently to stop bleeding n }}n }}Incorrect application can have serious consequences, including death. n }}n }}Combat Application Tourniquet® in occupational first aid n }} n }} "According to the ERC, current research indicates that the use of tourniquets can be useful for serious injuries with heavy blood loss. If a company has decided to introduce tourniquet systems into the company first aid programme due to the particular risk situation [in terms of occupational health and safety], the application must be instructed and practised regularly." (Source: DGUV - First Aid Division / May 2017)

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Combat Application Tourniquet® (CAT®) - Black

Basic colour: Black

WERO is the exclusive importer for Germany and Austria CAT® Tourniquet: Quality that counts - the original! The Combat Application Tourniquet® or simply CAT® is a one-hand tourniquet system for rapid haemostasis in the event of life-threatening bleeding from the extremities. What are the advantages of a CAT® Tourniquet? An individually adjustable strap allows the tourniquet to be applied to most extremitiesA robust, ergonomic toggle facilitates gripping and turning The wind system (strap with toggle) tensions a freely movable inner strap to prevent the flow of arterial blood into the extremity Only one handle is required to secure the toggle under a clamping hook During transport, the CAT® 's Velcro fastener provides additional security How do I use a tourniquet? The CAT® tourniquet is an essential component of tactical casualty care. It is used during major incidents, such as terrorist attacks, and as the first measure in the event of life-threatening haemorrhaging. The use of a tourniquet should be trained, but the following applies: in an absolute emergency and if all other rescue measures, such as a tourniquet, are unsuccessful, anyone can use a tourniquet. The tourniquet can also be applied with one hand in an emergency. 1. Unfold the CAT® so that the strap forms an O-shaped loop. Then apply the CAT® above the haemorrhage in the direction of the torso. To do this, pass the injured limb through the O-shaped loop of the Velcro strap. 2. Tighten the strap so that no more than two fingertips can fit between the tourniquet and the limb. Then firmly connect the Velcro surfaces together. 3. Now turn the gag until the bleeding stops and the pulse can no longer be felt below the wound site. 4. Secure the gag under the clamping hook. Check the bleeding and pulse again - if necessary, increase the pressure by turning the gag further. 5. Now place the end of the strap over the toggle and clamp hook and secure both with the safety Velcro. Then, if possible, make a note of the time of attachment. How can I recognise a fake? There are many copies of this tourniquet. They may not be able to build up the necessary pressure, become loose or tear. Do not jeopardise the life you are trying to save again. Please make sure you get the original from a reliable source. Visually, the differences between genuine and counterfeit tourniquets can be slight and are often difficult to recognise. In some cases, however, the following clues can be used to identify a replica: Red tip outside the USA No or inferior instructions for use: These are often not available in German and do not show the most important data and details of a medical device, such as the manufacturer, EC-REP or importer. Qualitative defects in counterfeits are characterised by the following features, for example:Inferior rods that are bendable and break easily under the required pressure A more extensive winding can make it difficult or even impossible to tighten sufficiently to stop bleeding Incorrect application can have serious consequences, including death. Combat Application Tourniquet® in occupational first aid "According to the ERC, current research indicates that the use of tourniquets can be useful for serious injuries with heavy blood loss. If a company has decided to introduce tourniquet systems into the company first aid programme due to the particular risk situation [in terms of occupational health and safety], the application must be instructed and practised regularly." (Source: DGUV - First Aid Division / May 2017)

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Combat Application Tourniquet® (CAT®) - Orange

Basic colour: Orange

WERO is the exclusive importer for Germany and Austria CAT® Tourniquet: Quality that counts - the original! The Combat Application Tourniquet® or simply CAT® is a one-hand tourniquet system for rapid haemostasis in the event of life-threatening bleeding from the extremities. What are the advantages of a CAT® Tourniquet? An individually adjustable strap allows the tourniquet to be applied to most extremitiesA robust, ergonomic toggle facilitates gripping and turning The wind system (strap with toggle) tensions a freely movable inner strap to prevent the flow of arterial blood into the extremity Only one handle is required to secure the toggle under a clamping hook During transport, the CAT® 's Velcro fastener provides additional security How do I use a tourniquet? The CAT® tourniquet is an essential component of tactical casualty care. It is used during major incidents, such as terrorist attacks, and as the first measure in the event of life-threatening haemorrhaging. The use of a tourniquet should be trained, but the following applies: in an absolute emergency and if all other rescue measures, such as a tourniquet, are unsuccessful, anyone can use a tourniquet. The tourniquet can also be applied with one hand in an emergency. 1. Unfold the CAT® so that the strap forms an O-shaped loop. Then apply the CAT® above the haemorrhage in the direction of the torso. To do this, pass the injured limb through the O-shaped loop of the Velcro strap. 2. Tighten the strap so that no more than two fingertips can fit between the tourniquet and the limb. Then firmly connect the Velcro surfaces together. 3. Now turn the gag until the bleeding stops and the pulse can no longer be felt below the wound site. 4. Secure the gag under the clamping hook. Check the bleeding and pulse again - if necessary, increase the pressure by turning the gag further. 5. Now place the end of the strap over the toggle and clamp hook and secure both with the safety Velcro. Then, if possible, make a note of the time of attachment. How can I recognise a fake? There are many copies of this tourniquet. They may not be able to build up the necessary pressure, become loose or tear. Do not jeopardise the life you are trying to save again. Please make sure you get the original from a reliable source. Visually, the differences between genuine and counterfeit tourniquets can be slight and are often difficult to recognise. In some cases, however, the following clues can be used to identify a replica: Red tip outside the USA No or inferior instructions for use: These are often not available in German and do not show the most important data and details of a medical device, such as the manufacturer, EC-REP or importer. Qualitative defects in counterfeits are characterised by the following features, for example:Inferior rods that are bendable and break easily under the required pressure A more extensive winding can make it difficult or even impossible to tighten sufficiently to stop bleeding Incorrect application can have serious consequences, including death. Combat Application Tourniquet® in occupational first aid "According to the ERC, current research indicates that the use of tourniquets can be useful for serious injuries with heavy blood loss. If a company has decided to introduce tourniquet systems into the company's first aid programme due to the special risk situation [in terms of occupational health and safety], the application must be instructed and practised regularly." (Source: DGUV - First Aid Division / May 2017)

Variants from €36.89*

From

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3. Error: incorrect positioning of the tourniquet

The position of the tourniquet is also crucial to the success of the emergency measure. It is often placed too close to the wound . As a general rule, you can orientate yourself by the fact that should be at least a hand's width away from the wound. If the artery is torn off, it can retract into the limb. In such cases, a hand-width distance from the wound is sometimes not sufficient to cause compression of the artery. Furthermore, the position must not be chosen directly above the knee or elbow . Sufficient compression is not possible here.

4. Mistake: insufficient pretensioning during application

A tourniquet must be placed sufficiently tightly around the limb before the gag is applied. A Velcro fastener is usually used for this purpose. If you do not close it tightly enough, the gag will not be able to develop its full effect. The consequence of this is insufficient compression, which does not stop the blood loss. You should therefore ensure a sufficiently tight fit when putting it on. It should not be possible to get three fingertips between the tourniquet and the extremity.

5. Error: Tourniquet safety device is forgotten

All known tourniquet models have a safety device. This prevents the toggle from moving freely and the compression from being released again. It is therefore important to use the safety device after applying . A further complication of inadequate securing is that the injured person may loosen the gag themselves. As strong compression leads to pain , this reaction of an injured person is not unlikely. If the safety device has been applied, it provides sufficient protection against unintentional loosening of the gag.

6. Error: The tourniquet is positioned over a joint

If positioned over a joint, sufficient compression of the injured artery is not possible. A tourniquet must therefore not be positioned directly over the knee or elbow.

In addition to joints, clothing and equipment worn on the body can also pose a problem. Pockets filled with objects on the sleeve or trouser leg of clothing act as a buffer and reduce compression. They must be removed or emptied before donning.

7. Error: the tourniquet is not applied horizontally

A tourniquet is usually applied intuitively in a horizontal position on the injured extremity. Depending on the positioning, however, it is also possible to deviate from the ideal position. In the worst case, this can lead to subsequent slippage and renewed bleeding. If it is applied distally with a hand's breadth distance to the groin or armpit, the anatomical conditions automatically ensure a horizontal fit.

8. Mistake: open wounds are not dressed

A tourniquet application is no substitute for initial wound care at the accident site! Use a sterile wound dressing to prevent dirt and germs from entering the open wound. Such wound contamination can delay the healing process due to inflammation . As amputation injuries sometimes also lead to bleeding from the bone, further wound care is essential. To do this, apply a pressure bandage. It also helps to stop the bleeding and prevents bleeding from the injured bone. In addition to the wound dressing, you should also ensure that the injury is kept still. This promotes blood clotting and increases the chances of survival.

9. Error: temporary opening of the tourniquet

If an injured person is in severe pain or is possibly resisting the tourniquet, civilian first aiders tend to temporarily loosen or open the gag. However, this immediately leads to blood flow through the injured artery and quickly becomes life-threatening. On the other hand, it should also be noted that a tourniquet application is limited in time. A duration of up to two hours is unproblematic and has no health consequences. Longer applications should only be carried out in unavoidable emergencies, as this can have consequences.

10. Error: no tourniquet is carried in the emergency kit

In addition to incorrect tourniquet use, there is another fatal tourniquet error: it is missing from the emergency kit or is not placed within easy reach. This is because in the event of serious arterial injuries with high blood loss, rapid action is required and the necessary tools must always be in perfect condition and ready to hand.

Conclusion

When used correctly, a tourniquet can prevent high blood loss through compression and thus save the life of a seriously injured person. Ideally, the tourniquet should be used by trained professionals who are familiar with the correct way to use it . However, in emergency situations, such as a road accident, even laypersons should not shy away from using a tourniquet if necessary!