Quote:
Originally Posted by rcm_18d
All of this is good but basics saves lives. The civilian EMS world is just now getting on line with the tourniquets first.
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I don't know that civilian EMS will ever be completely on board with the widespread use of tourniquets. In the urban settings, a hospital is usually minutes away as opposed to awaiting medevac from a battlefield then an extended transport time to an aid station.
There is a price that is paid when using a tourniquet in terms of tissue damage, both muscular and neurovascular and it is dependent on the ischemic time of the limb involved. Even though the patient may ultimately lose the extremity, you have to keep in mind the rehabilitative potential and prosthetics. If I had to chose, a below the knee amputation is preferable to above because it spares the joint. It helps to salvage as much distally as possible. If the injury is complete amputation, you don't have a lot of choice where stopping the hemorrhage is concerned. For less, though, the basics, e.g. direct pressure and the use of hemostatic agents are the answer.
My opinion..