[Fr. tourniquet, turnstile, turning instrument]
Any constrictor used on an extremity to apply pressure over an artery and thereby control bleeding. It is also used to distend veins to facilitate venipuncture or intravenous injections.
Arterial hemorrhage: In emergencies, the tourniquet is applied between the wound and the heart, close to the wound, placing a hard pad over the point of pressure. This should be discontinued as soon as possible and a tight bandage substituted under the loosened tourniquet.
SEE: arterial bleeding for table
A tourniquet should never be left in place too long. Ordinarily, it should be released from 12 to 18 min after application to determine whether bleeding has ceased. If it has, the tourniquet is left loosely in place so that it may be retightened if necessary. If bleeding has not ceased, it should be retightened at once. In general, a tourniquet should not be used if steady firm pressure over the bleeding site will stop the flow. As an adjunct to surgery on extremities, a pneumatic tourniquet is applied after exsanguinating the limb with an Esmarch or similar bandage. The time a surgical tourniquet is inflated and the pressure to which it is inflated depend upon the age of the patient, body habitus, upper vs. lower extremity, etc., according to established guidelines. The tourniquet is released at appropriate intervals to prevent tissue damage due to ischemia. An additional application utilizes two tourniquets or a double cuff tourniquet for retrograde intravenous nerve block, e.g., Bier block.
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