Types of Tourniquets
The tourniquet, a basic device used to constrict and compress arteries and veins, is essential in surgical and emergency situations. In its emergency use, it is used to stop severe bleeding. In its surgical use, it allows surgeons to work in a bloodless operative environment.
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History
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The tourniquet dates as far back as the time of the Ancient Greeks and Romans. Documents describe the use of compression devices to control excessive bleeding of limbs during military campaigns. In 1718, French surgeon Louis Petit devised a screw-based device more closely resembling the notion of the traditional tourniquet. In fact, Petit named the device a "tourniquet" based on the French word "tourner," meaning "to turn." Of similar importance, Joseph Lister (1827-1912) has gained credit as the first to have used a tourniquet to create a bloodless surgical field. By 1873, Johann Von Esmarch constructed a tourniquet out of a superior material, namely rubber. In 1904, a major breakthrough occurred with Harvey Cushing's inflatable model, applied with compressed gas. This model could be applied and removed very quickly and thus limit nerve paralysis, a common effect of the application of earlier models. With the advent of the early 1980s, the design of the tourniquet saw significant improvement, as James McEwen invented an electronic device utilizing a microprocessor.
Types
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As of 2009, there are two basic types of tourniquets: surgical tourniquets and emergency tourniquets. Of the surgical tourniquets, there are two basic designs: noninflatable (nonpneumatic) tourniquets and pneumatic tourniquets. Modern surgery today makes extensive use of the pneumatic tourniquets, as they are more convenient and safe. The pneumatic tourniquet makes use of gas entering an inflatable cuff, which is regulated by a device on the apparatus. In this way, the amount of pressure exerted on the limb can be carefully controlled. The emergency tourniquet is often hastily constructed out of spare cloth and a loose stick used to twist the cloth. Emergency tourniquets are generally used as a last resort to stop severe bleeding.
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Surgical Use
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In a surgical setting, the tourniquet prevents blood flow to the limbs and allows surgeons to operate in a bloodless field. The benefits of the surgical tourniquet allow the surgeons to perform precise procedures in shorter periods of time. In addition, the tourniquet grants the surgeons and the patient added safety.
Non-Surgical Use
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The emergency tourniquet is used as a last resort due to the potentially devastating effects of its application. This non-surgical use of the tourniquet is found commonly in the military, as quick application of a tourniquet to a wounded soldier can often save the the soldier's life.
Hazards
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The use of the emergency tourniquet makes the recipient susceptible to severe nerve damage. Due to this fact, the loss of the limb below the application is not uncommon. The sudden stoppage of blood flow to the tissue below the tourniquet frequently results in the death of the tissue. An emergency tourniquet that has been applied for several hours is indeed sure to cause a degree of damage resulting in the necessity of amputating the limb. Nerve injury and paralysis is not exclusive to the use of the emergency tourniquet, as this can also be found in the use of the surgical tourniquet. Complications arise when the tourniquet is applied improperly or without sufficient pressure.
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