Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care—Part 1: Tourniquets

Visual estimates of blood loss by medical laypeople: Effects of blood loss volume, victim gender, and perspective

“…In traumatic bleeding injuries, fast and accurate hemorrhage control may be the difference between life and death [ 7 ]. The amount and rate of blood loss, the location of the injury, and characteristics of the situation should all factor into the clinical decision process for appropriate interventions [ 8 – 10 ]. In a blood-loss related emergency, the immediate responders must determine if the injury is life-threatening and which hemorrhage control technique to use (e.g., direct pressure, a tourniquet, or wound packing combined with direct pressure; [ 11 ]).…”

Educating the Educator: Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care—Part 2: Hemostatic Agents

“…1 All methods of controlling hemorrhage serve to restrict blood flow and augment the body's response to blood loss-vascular constriction, platelet aggregation, and coagulation. In the presence of shock (see Part 1) 2 and uncontrollable bleeding, athletic trainers may consider the use of a tourniquet, 2 while paramedics in the prehospital setting may implement invasive treatments to include intravenous fluid resuscitation and vasoactive therapies. Failure to manage blood loss may result in an individual becoming hemodynamically unstable.…”

“…This condition, known as shock, is often defined as inadequate tissue perfusion. 2,3 The inability of the body to perfuse oxygen to the cellular tissues and remove waste products may occur with as little as 15 to 20% loss of the total blood volume in adults. [4][5][6]…”

“…7 A tourniquet is a tight band (commercial or improvised) placed around an arm or leg to constrict blood vessels to stop blood flow to a wound. 2 In some instances, the presence of excessive soft tissue or proximity of blood vessels within soft tissue may necessitate the application of multiple tourniquets. Subsequent applications of additional tourniquet (based on the severity of the injury) must be applied proximal to the initial tourniquet as practically close as possible to the injury.…”

“…More information regarding tourniquet usage and teaching strategies in athletic training can be found in Part 1 of this 2-part series (Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care-Part 1: Tourniquets). 2 When presented with trauma situations where massive external bleeding cannot be controlled by direct pressure and/or with the use of a tourniquet (ie, hemorrhaging occurring in sites not amenable to tourniquet placement such as the abdomen, groin, or chest), the application of a topical hemostatic agent is warranted. [7][8][9][10]…”