Circulation/Hemorrhage Control in TFC

What to remember

• In the circulation step, recheck every earlier tourniquet and hemostatic dressing; a tourniquet that is not working gets a second one beside it.CLS M09 Slides, PDF p.9
• Never apply a tourniquet and forget it. Recheck often and every time the casualty is moved or changes, and watch for shock.CLS M09 Notes, PDF p.4
• Suspect a pelvic fracture after blunt force or a blast with pelvic pain, a major lower-limb amputation, bruising or deformity near the pelvis, an unstable pelvis, or unconsciousness or shock. Tell medical personnel early.CLS M09 Notes, PDF p.3
• Pack a wound with hemostatic gauze while pressing constantly (within 90 seconds), hold pressure at least 3 minutes, and only then add a pressure bandage.CLS M09 Slides, PDF p.17
• If a pressure bandage fails or is soaked, put a tourniquet 2-3 inches above the wound if you can; if you cannot, replace the dressing with new hemostatic gauze.CLS M09 Notes, PDF p.5
• Replace a tourniquet that was put on over the uniform, sits more than 3 inches above the wound, or may stay on more than 2 hours before surgery. Put the new one on first, then slowly loosen the old one.CLS M09 Slides, PDF p.11
• Do not convert a tourniquet to a dressing if the casualty is in shock, has an amputation, or cannot be watched for rebleeding; think twice if it has been on more than 6 hours.CLS M09 Slides, PDF p.13

Where people go wrong

• Applying a tourniquet or dressing and then forgetting it instead of rechecking it often.CLS M09 Slides, PDF p.10
• Checking under the gauze during the 3-minute pressure hold instead of keeping steady pressure.CLS M09 Notes, PDF p.4
• Converting a tourniquet in a casualty who is in shock, has an amputation, or cannot be closely watched for rebleeding.CLS M09 Slides, PDF p.13
• Removing a tourniquet that has already been on longer than 6 hours.CLS M09 Skill Instructions, PDF p.4

Check yourself

Questions on this module, each with the reason and the slide it came from.