Surgical tourniquet

A tourniquet is a constricting or compressing device, specifically a bandage, used to control venous and arterial circulation to an extremity for a period of time. Pressure is applied circumferentially upon the skin and underlying tissues of a limb; this pressure is transferred to the walls of vessels, causing them to become temporarily occluded. It is generally used as a tool for a medical professional in applications such as cannulation or to stem the flow of traumatic bleeding, especially by military medics. The tourniquet is usually applied when the patient is in a life-threatening state as a result of continuous bleeding.

A primitive tourniquet can be made from a stick and a rope (or leather belt). The rope is made into a loop that fits over the damaged limb and the stick is inserted through the loop. The loop is tightened by twisting the stick. This primitive device stems the flow of blood but side-effects such as tissue damage and nerve damage may occur. In modern medicine, pre-assembled devices have been developed. They avoid side-effects of the traditional rope-and-stick tourniquets and can be faster or easier to apply. Some modern tourniquets, such as the Combat Application Tourniquet or the SOF Tourniquet can be applied with one hand by the injured person himself. However, it does require some practice to ensure it is applied correctly and quickly.

During Alexander the Great’s military campaigns in the fourth century BC, tourniquets were used to stanch the bleeding of wounded soldiers.Romans used them to control bleeding, especially during amputations. These tourniquets were narrow straps made of bronze, using only leather for comfort.

In 1718, French surgeon Jean Louis Petit developed a screw device for occluding blood flow in surgical sites. Before this invention, the tourniquet was a simple garrot, tightened by twisting a rod (thus its name , from = to turn).

In 1785 Sir Gilbert Blane advocated that, in battle, each Royal Navy sailor should carry a tourniquet:

“It frequently happens that men bleed to death before assistance can be procured, or lose so much blood as not to be able to go through an operation. In order to prevent this, it has been proposed, and on some occasions practised, to make each man carry about him a garter, or piece of rope yarn, in order to bind up a limb in case of profuse bleeding. If it be objected, that this, from its solemnity may be apt to intimidate common men, officers at least should make use of some precaution, especially as many of them, and those of the highest rank, are stationed on the quarter deck, which is one of the most exposed situations, and far removed from the cockpit, where the surgeon and his assistants are placed. This was the cause of the death of my friend Captain Bayne, of the Alfred, who having had his knee so shattered with round shot that it was necessary to amputate the limb, expired under the operation, in consequence of the weakness induced by loss of blood in carrying him so far. As the Admiral on these occasions allowed me the honour of being at his side, I carried in my pocket several tourniquets of a simple construction, in case that accidents to any person on the quarter deck should have required their use.”

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Wikipedia