Tourniquets and haemostatic dressings

Under new guidelines from the Resuscitation Council (UK) Guidelines Haemostatic dressings and tourniquets are to be used when direct pressure cannot control severe bleeding.

The treatment for catastrophic bleeding has changed – Tourniquets and haemostatic dressings are now to be used. Elevation and indirect pressure have been removed due to a lack of evidence that either is effective in stopping bleeding.

One thing we spoke about in the past was that the limb could be damaged or lost if the tourniquet was left on too long. The times quoted were in the region of 15 minutes.

However new research now shows where the loss of a limb is likely, the tourniquet would need to be applied for 6 hours. The fact is that we can usually get help in minutes rather than hours; the risks to the patient of not applying a tourniquet or applying it incorrectly far outweigh the risk of applying it correctly.

Following extensive use and research in combat, there is a wealth of evidence that tourniquets are effective; they save lives and have a relatively low rate of complications following application. Similarly, haemostatic dressings have also undergone significant improvements in recent years, have low complication rates and have saved many lives.

The balance of complications versus possible outcomes if not used have led to both tourniquets and haemostatic dressings being introduced into main-stream first aid. Of course, a small office workplace is unlikely to find that catastrophic bleeding is a significant risk to their employees; so they wouldn’t necessarily have to rush out and buy this new equipment. A waste recycling plant or tree surgeon on the other hand may wish to consider having these available.

The good news is that the guidelines are very clear that “training is required to ensure application is safe and effective”.

Teesside First Aid instructors have now been trained on the use of Tourniquets and haemostatic dressings; and can add this high risk element to any first aid course.

Each business should conduct a risk assessment as recommended by the HSE. Where a high risk has been found for the potential for catastrophic bleeding then the high risk course should be chosen over the normal FAW courses. The HSE have suggested businesses involved in construction, agriculture, forestry and manufacturing to name a few should consider this course.

Please contact us if you have any questions regarding this.

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