Tourniquet: Not Always a Life or Limb Decision

Emergency medical services (EMS) training discourages the belief that the application of a tourniquet is always a life or limb decision. While this is true for severe bleeding control on the battle field, life or limb does not necessarily apply when it comes to civilian use. A tourniquet is a last resort procedure to control bleeding because it consists of cutting off the blood supply to a limb which invites the threat of a possible amputation as blood flow is restricted to the limb eventually causing its death. Unless bleeding control takes place in a very remote place like the wilderness or during the rescue of a patient who is entrapped for a prolonged period of time, the use of a tourniquet does not have to be a life or limb situation because transport to a hospital rarely takes longer than an hour.

Updated Precautions for the Use of a Tourniquet

Anyone who has been trained to know when and how to use a tourniquet understands that such a device can be improvised using the most primitive materials. It's also understood that material should be at least 2 inches wide to prevent cutting into the skin and preferably no wider than 4 inches to be effective. Some people have also been told that a tourniquet should be loosened approximately every twenty minutes to help reduce the threat of amputation. Modern EMS training, however, instructs emergency medical technicians (EMTs) of all levels and paramedics to leave a tourniquet in place once applied unless otherwise ordered by medical direction. One thing many people might not remember or know when needing to improvise for a tourniquet is that a plain blood pressure cuff can be used. If used as a tourniquet, it should be closely monitored to make sure it does not deflate.

Hemostatic Agents: Alternatives to a Tourniquet for Bleeding Control

Some EMS systems attempt to avoid making a true life or limb decision even when needing to control bleeding in remote areas or during prolonged entrapment by authorizing the use of hemostatic agents. Hemostatic agents usually come in the form of dressings which contain a special absorbent substance that actually traps red blood cells, thus helping to accelerate the natural clotting process to control bleeding. These dressings are generally available in pharmacies and some stores selling sporting goods. The dressings are placed directly into the wound. It's an excellent idea to purchase hemostatic dressings if planning a trip to a remote location such as the wilderness. Their use has sometimes prevented having to resort to using a tourniquet.

Source:

My EMT training/experience (current state license, current NREMT certification)