COMPLICATIONS ASSOCIATED WITH APPLYING A TOURNIQUET ON THE BATTLEFIELD IN PATIENTS WITH DAMAGE TO MAJOR LIMB VESSELS

Abstract

Summary. The use of a tourniquet to control bleeding is often necessary in the treatment of patients with vascular injuries of the extremities. Properly performed, tourniquet application can save lives, particularly in extreme conditions such as the battlefield. However, incorrect or prolonged tourniquet application can result in the most common type of peripheral nerve damage, known as neuropraxia. In this article, we present and review six cases of tourniquet application on the battlefield that resulted in nerve damage. Our findings confirm the need to improve the training of medical personnel in the use of tourniquets. We provide practical recommendations to prevent post-tourniquet syndrome: In cases of limb injury, a medical professional or the wounded person, if able, should loosen the tourniquet and examine the bleeding wound every two hours. If there are no signs of massive bleeding, the tourniquet should be replaced with a pressure bandage. During examination, medical personnel should carefully identify signs of threatened limb ischaemia, such as pain, tingling, burning sensation, a feeling of ‘girdling’ around the limb, or discolouration. This is important to prevent post-turnstile syndrome.