o Circulation
• Hemorrhage control
• Elevation and pressure points de-emphasized
o Elevation of an injured extremity may worsen injuries
(convert closed fracture to open)
o No data that elevation or pressure points improves
outcome of injured trauma patients
• Tourniquets
o Used safely in operating rooms for years
o Documented efficacy in recent military applications
o Device can be a manufactured tourniquet, a blood
pressure cuff or a cravat tied into a “Spanish windlass”
o Applied just proximal to the site of hemorrhage, and
tightened until bleeding stops
o Mark time tourniquet applied on the tourniquet; leave the
site exposed for visual monitoring of hemorrhage
o Box note on sample tourniquet protocol[/quote]