body, since its use in these locations would result in
greater injury or death. A tourniquet should be used on
an injured limb only as a last resort for severe,
You should try the direct-pressure method first to
life-threatening hemorrhaging that cannot be controlled
control bleeding. Place a sterile first-aid dressing, when
by any other method. A tourniquet must be applied
available, directly over the wound. Tie the knot only
ABOVE the wound--that is, towards the trunk--and it
tight enough to stop the bleeding, and firmly fasten it
must be applied as close to the wound as practicable.
in position with a bandage. In the absence of sterile
dressings, use a compress made with a clean rag,
Any long, flat material can be used as a band for a
handkerchief, or towel to apply direct pressure to the
tourniquet--belts, stockings, flat strips of rubber, or a
wound, as in figure 1-2. If the bleeding does not stop,
neckerchief. Only tighten the tourniquet enough to stop
firmly secure another dressing over the first dressing, or
the flow of blood. Use a marker, skin pencil, crayon, or
apply direct pressure with your hand or fingers over the
blood, and mark a large T on the victim's forehead.
dressing. Under no circumstances is a dressing to be
removed once it is applied.
If the direct-pressure method does not stop the
Remember, a tourniquet is only used as
bleeding, use the pressure point nearest the wound, as
a last resort to control bleeding that cannot
shown in figure 1-3. Bleeding from a cut artery or vein
be controlled by other means. Tourniquets
may often be controlled by applying pressure to the
should be removed as soon as possible by
appropriate pressure point. A pressure point is a place
medical personnel only.
where the main artery to the injured part lies near the
skin surface and over a bone. Pressure at such a point
is applied with the fingers or with the hand; no first-aid
materials are required. Pressure points should be used
with caution, as they may cause damage to the limb as
The causes of burns are generally classified as
a result of an inadequate flow of blood. When the use
thermal, electrical, chemical, or radiation. Whatever the
of pressure points is necessary, do not substitute them
cause, shock always results if the burns are extensive.
for direct pressure; use both.
Thermal burns are caused by exposure to intense
Use of a Tourniquet
heat, such as that generated by fire, bomb flash,
sunlight, hot liquids, hot solids, and hot gases. Their
A tourniquet is a constricting band that is used to
care depends upon the severity of the bum and the
cut off the supply of blood to an injured limb. It cannot
percentage of the body area involved.
be used to control bleeding from the head, neck, or
Electrical burns are caused by electric current
passing through tissues or the superficial wound caused
by electrical flash. They may be far more serious than
they first appear. The entrance wound may be small;
but as electricity penetrates the skin, it burns a large
area below the surface. Usually there are two external
burn areas: one where the current enters the body, and
another where it leaves.
Chemical burns for the most part are not caused by
heat, but by direct chemical destruction of body tissues.
When acids, alkalies, or other chemicals come in
contact with the skin or other body membranes, they
can cause injuries that are generally referred to as
chemical burns. The areas most often affected are the
Figure 1-2.--Direct pressure.
extremities, mouth, and eyes. Alkali burns are usually