KC gives a pretty good list. I would add locking hemostats. Squirting arteries can be slippery little bastards. But once clamped, they can be controlled.
I am sure that most here are First Aid trained, and know about tourniquets and the dangers thereof.
For the one or two who might not.
1a: Use of a tourniquet will "sacrifice the limb to save the life". Most times, a pressure bandage coupled with pressure upon the "pulse point" will minimize bleeding without cost of the limb. Clot powder or clotting bandages will be of assistance.
1b: Assume all tissue below the tourniquet will have to be cut off.
2: Once applied, NEVER, Never loosen a tourniquet before arrival at the ER. Let ER Dr do it.
3: tag the tourniquet with date and time of application.
Tourniquets are an absolute last course attempt used after all else fails in an attempt to save a life. Do not make the decision to use one lightly.
Idaho Shooter:
I was taught the same things as you and that, at least for me, was a long time ago.
I recently had the opportunity to listen to a presentation by a trauma surgeon who learned his trade in Iraq. I got to ask some questions and he told us that strategies have changed. We participated in a hands-on seminar on how to administer a tourniquet and how to pack a wound to prevent internal bleeding. This is what he said.
#1 You have to know how to pack a wound to stop internal bleeding.
#2 Put a tourniquet on and it can stay put for up to four hours without losing the limb.
#3 He was a combat zone surgeon and the goal of the medics and chopper pilots is to get the patient to the M.A.S.H. unit ASAP. If you can do that, then even the most seriously wounded can be saved.
Now take into consideration that he was in a combat zone and one could reasonably expect emergency transportation to arrive in a timely manner. So one has to analyze the current situation to determine if what he said applies.
