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Tourniquet
A tourniquet is a device that is used to apply pressure to a limb or extremity in order to stop the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation. A simple tourniquet can be made from a stick and a rope, but the use of makeshift tourniquets has been reduced over time due to their ineffectiveness compared to a commercial and professional tourniquet. This may stem the flow of blood, but side effects such as soft tissue damage and nerve damage may occur. Types There are three types of tourniquets: surgical tourniquets, emergency tourniquets, and rehabilitation tourniquets. Surgical tourniquets Silicone ring tourniquets, or elastic ring tourniquets, are self-contained mechanical devices that do not require any electricity, wires or tubes. The tourniquet comes in a variety of sizes. To determine the correct product size, the patient's limb circumference at the desired occlusion location should be measured, as well as their bl ...
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Tourniquet
A tourniquet is a device that is used to apply pressure to a limb or extremity in order to stop the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation. A simple tourniquet can be made from a stick and a rope, but the use of makeshift tourniquets has been reduced over time due to their ineffectiveness compared to a commercial and professional tourniquet. This may stem the flow of blood, but side effects such as soft tissue damage and nerve damage may occur. Types There are three types of tourniquets: surgical tourniquets, emergency tourniquets, and rehabilitation tourniquets. Surgical tourniquets Silicone ring tourniquets, or elastic ring tourniquets, are self-contained mechanical devices that do not require any electricity, wires or tubes. The tourniquet comes in a variety of sizes. To determine the correct product size, the patient's limb circumference at the desired occlusion location should be measured, as well as their bl ...
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Tourniquet
A tourniquet is a device that is used to apply pressure to a limb or extremity in order to stop the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation. A simple tourniquet can be made from a stick and a rope, but the use of makeshift tourniquets has been reduced over time due to their ineffectiveness compared to a commercial and professional tourniquet. This may stem the flow of blood, but side effects such as soft tissue damage and nerve damage may occur. Types There are three types of tourniquets: surgical tourniquets, emergency tourniquets, and rehabilitation tourniquets. Surgical tourniquets Silicone ring tourniquets, or elastic ring tourniquets, are self-contained mechanical devices that do not require any electricity, wires or tubes. The tourniquet comes in a variety of sizes. To determine the correct product size, the patient's limb circumference at the desired occlusion location should be measured, as well as their bl ...
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Emergency Tourniquet
Emergency tourniquets are cuff-like devices designed to stop severe traumatic bleeding before or during transport to a care facility. They are wrapped around the limb, proximal to the site of trauma, and tightened until all blood vessels underneath are occluded. The design and construction of emergency tourniquets allows quick application by first aid responders or the injured persons themselves. Correct use of tourniquet devices has been shown to save lives under austere conditions with comparatively low risk of injury. In field trials, prompt application of emergency tourniquets before the patient goes into shock are associated with higher survival rates than any other scenario where tourniquets were used later or not at all. Tourniquet design Existing guidelines call for the use of improvised "rope-and-stick" tourniquets as a last resort to stop severe bleeding. However, purpose-made tourniquet devices that are well designed can provide greatly increased safety and efficacy. V ...
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Battlefield Medicine
Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first developed to treat the wounds inflicted during combat. With the advent of advanced procedures and medical technology, even polytrauma can be survivable in modern wars. Battlefield medicine is a category of military medicine. Chronology of battlefield medical advances * During Alexander the Great’s military campaigns in the fourth century BC, tourniquets were used to stanch the bleeding of wounded soldiers. Romans used them to control bleeding, especially during amputations. These tourniquets were narrow straps made of bronze, using only leather for comfort. * An early stretcher, likely made of wicker over a frame, appears in a manuscript from c.1380. Simple stretchers were common with militaries right through the middle of the 20th c ...
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Intravenous Regional Anesthesia
Intravenous regional anesthesia (IVRA) or Bier's block anesthesia is an anesthetic technique on the body's extremities where a local anesthetic is injected intravenously and isolated from circulation in a target area. The technique usually involves exsanguination of the target region, which forces blood out of the extremity, followed by the application of pneumatic tourniquets to safely stop blood flow. The anesthetic agent is intravenously introduced into the limb and allowed to diffuse into the surrounding tissue while tourniquets retain the agent within the desired area. History The use of tourniquets and injected anesthesia to induce localized anesthesia was first introduced by August Bier in 1908. He used an Esmarch bandage to exsanguinate the arm and injected procaine between two tourniquets to rapidly induce anesthetic and analgesic effects in the site. Though it proved effective, IVRA remained relatively unpopular until C. McK. Holmes reintroduced it in 1963. Today, t ...
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Ischemia-reperfusion Injury Of The Appendicular Musculoskeletal System
Ischemia-reperfusion (IR) tissue injury is the resultant pathology from a combination of factors, including tissue hypoxia, followed by tissue damage associated with re-oxygenation. IR injury contributes to disease and mortality in a variety of pathologies, including myocardial infarction, ischemic stroke, acute kidney injury, trauma, circulatory arrest, sickle cell disease and sleep apnea. Whether resulting from traumatic vessel disruption, tourniquet application, or shock, the extremity is exposed to an enormous flux in vascular perfusion during a critical period of tissue repair and regeneration. The contribution of this ischemia and subsequent reperfusion on post-traumatic musculoskeletal tissues is unknown; however, it is likely that similar to cardiac and kidney tissue, IR significantly contributes to tissue fibrosis. Definitions * " Ischemia": an inadequate blood supply to an organ or part of the body. * " Reperfusion": the restoration of blood flow to an organ or tissue af ...
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Tourniquet Test
A tourniquet test (also known as a Rumpel-Leede capillary-fragility test or simply a capillary fragility test) determines capillary fragility. It is a clinical diagnostic method to determine a patient's haemorrhagic tendency. It assesses fragility of capillary walls and is used to identify thrombocytopenia (a reduced platelet count). The test is part of the WHO algorithm for diagnosis of dengue fever. A blood pressure cuff is applied and inflated to the midpoint between the systolic and diastolic blood pressures for five minutes. The test is positive if there are more than 10 to 20 petechiae A petechia () is a small red or purple spot (≤4 mm in diameter) that can appear on the skin, conjunctiva, retina, and mucous membranes which is caused by haemorrhage of capillaries. The word is derived from Italian , 'freckle,' of obscure origi ... per square inch. Limitations Some studies have shown that the tourniquet test may not have high specificity. Interfering factors with thi ...
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Hair Tourniquet
Hair tourniquet is a condition where hair or thread becomes tightly wrapped around most commonly a toe, and occasionally a finger, genitals, or other body parts. This results in pain and swelling of the affected part. Complications can include tissue death due to lack of blood flow. It occurs most commonly among children around 4 months of age, though cases have been described in older children and adults. Most cases occur accidentally. Risk factors may include autism and trichotillomania. The mechanism is believed to involve wet hair become wrapped around a body part and then tightening as it dries. Diagnosis involves examination of the entire child. Prevention is by keeping the parent's hair from contact with the baby such as by the parent keeping their hair brushed and back and washing the baby's clothing separately. Treatment is with a substance that breaks down hair or cutting through the hair. The condition is rare. Males and females are equally frequently affected. The ...
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Emergency Bleeding Control
Emergency bleeding control describes actions that control bleeding from a patient who has suffered a traumatic injury or who has a medical condition that has caused bleeding. Many bleeding control techniques are taught as part of first aid throughout the world, though some more advanced techniques such as tourniquets, are often taught as being reserved for use by health professionals, or as an absolute last resort, to mitigate associated risks, such as potential loss of limbs. To manage bleeding effectively, it is important to be able to readily identify types of wounds and types of bleeding. Types of wounds Wounds are normally described in a variety of ways. Descriptions may include wound size (length) and thickness; plainly visible wound characteristics such as shape and open or closed; and origin, acute or chronic. The most common descriptors of wounds are these: * ''Incision:'' Straight edges to the wound margins, as if sliced with a knife. These can vary in size, and ...
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Gilbert Blane
Sir Gilbert Blane of Blanefield, 1st Baronet FRSE FRS MRCP (29 August 174926 June 1834) was a Scottish physician who instituted health reform in the Royal Navy. He saw action against both the French and Spanish fleets, and later served as a Commissioner on the Sick and Wounded Board of the Admiralty. Life Born in Blanefield, by Kirkoswald, in Ayrshire, he was the fourth son of Gilbert Blane of Blanefield (d.1771) and Agnes McFadzen. He studied medicine at Edinburgh University and Glasgow University (MD 1778) before moving to London. The challenge of establishing a practice in London was eased by his friendship with Dr William Hunter, elder brother of the famous John Hunter who is now widely regarded as the father of modern surgery in Britain. Dr William Hunter introduced Blane to Lord Rodney who appointed Blane as his personal physician aboard HMS ''Sandwich''. Blane was appointed Physician to the Fleet (1779–1783) and accompanied Rodney, initially to pursue the S ...
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Vascular Occlusion Training
Blood flow restriction training / Occlusion Training (also abbreviated BFR training) or Occlusion Training or KAATSU is an exercise and rehabilitation modality whereby resistance exercise, aerobic exercise or physical therapy movements are performed whilst using an Occlusion Cuff is applied to proximal aspect of the muscle on either the arms or legs. In this novel training method developed in Japan by Dr. Yoshiaki Sato in 1966, limb (legs or arms) venous blood flow is restricted via the occlusion cuff throughout the contraction cycle and rest period. This result is partial restriction of arterial inflow to muscle, but, most significantly, restricts venous outflow from the muscle. Given the light-load nature and strengthening capacity of BFR training, it can provide an effective clinical rehabilitation stimulus without the high levels of joint stress and cardiovascular risk associated with heavy-load training. Application Many practitioners include physical therapists, orthopedic su ...
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Bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. Types * Upper head ** Intracranial hemorrhage – bleeding in the skull. ** Cerebral hemorrhage – a type of intracranial hemorrhage, bleeding within the brain tissue itself. ** Intracerebral hemorrhage – bleeding in the brain caused by the rupture of ...
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