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How Tight to make a Tourniquet
I enjoy this subject because when the adrenaline is flowing in the thick of things, it is sometimes forgotten how tight is toooooooo tight.
Remember, just tight enough to slow/stop the bleeding!!! Generally, the artery spasms and shuts itself off but the vein stays wide open and flowing...the vein is a LOW pressure system therefore not much pressure is needed.
Picture #1 is an arm that another hospital wrapped up (pseudo-tourniquet) and sent to us..pt. had a badly lacerated brachial artery, significant hemorrhage and forgot their 'basic' skills
Picture #2 is the same arm, close up of the mottled hand...tooooo tight
*****pics too big, I'll shrink them and post later
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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