Question about tourniquets

[Selena]

So my character is fighting in this arena and she receives a wound to the leg. She has to fight another fight immediately after with no medical attention. A few questions
-At what point would she need a tourniquet?
-If she needed one, what would be the chances she wouldn't lose her leg with a skilled medic?
-How long can a tourniquet be on?
-With a tourniquet on, how difficult would it be to fight? (not with a sword or anything, she has magic that she can use. More the mobility side of it)
-Could a bone be used to tie the tourniquet instead of a stick? (She has magic that would allow her to sever the bones from an opponent she just killed pretty easily and there are no sticks in the arena)

 

[Rosemary Tea]

If she had a tourniquet on her leg, that leg would be useless. She wouldn't be able to keep fighting. What tourniquets do is cut the circulation completely. You need circulation in a limb to be able to use it.

Tourniquets may be used in case of severe, life threatening bleeding, and they're a last resort. The first step is to put direct pressure on the wound. If that's not stopping it fast enough, that's when you'd consider a tourniquet. And that's first aid protocol that's changed in recent years. For decades, tourniquets were not advised at all.

If she needs a tourniquet, she's bleeding so severely that her life is in danger. If she's bleeding that severely, she's too injured to fight. With a less severe wound, she might be able to keep fighting after some first aid, but then there would be no question of a tourniquet.

 

[Mad Swede]

OK, assuming you don't have modern medical technology in your fantasy world. And writing this as someone who has had to apply a tourniquet to a severely injured colleague (yes, they survived - but were so severely hurt that they were medically retired).

Generally, the first thing you do if someone has a very deep wound is stuff it with clean cloths and then put presure on the wound to stop the bleeding. If this doesn't work you apply a tourniquet. Either way, the injury will be so severe that the person won't be able to continue fighting and in reality the person would probably be unconscious due to blood loss.

If you can stop the bleeding without a tourniquet then there is a chance that the injury will eventually heal and the person will have use of the limb to some degree - the injury itself determines how much use they have.

If you end up applying a tourniquet then the chances are that the person will lose the limb. Modern medical technology is such that if you can get the person to a suitably equipped medical post quickly enough (within 60 minutes, preferably within 30 minutes) they can often save the limb, but if that doesn't exist in your world then the character will lose the limb. The tourniquet itself is very painful (yes, we practised on one another) - it has to be very tight to be effective. Just tying a rope or belt around the limb won't be enough - you need to tighten the rope around the limb with something like a thick wooden stick or metal bar to apply enough pressure. There is no way at all that you can use a limb after a tourniquet has been applied.

In both cases the person will probably live, provided that they survive the initial combination of shock and blood loss - this is not a given, and the first 20 minutes or so after being injured are critical. After that, the degree of infection will determine how things go - gangrene is a real risk. Using hot wine to clean the would will help keep infection down, but won't eliminate it completely.

 

[Selena]

Okay, thank you. This helps!

 

[Karlin]

Medics are are taught to mark on a person's forehead if they have a tourniquet and what time it was put in place, so that when the wounded soldier reaches a field hospital they'll know what the situation is immediately.

 

[CupofJoe]

The tourniquet itself is very painful (yes, we practised on one another) - it has to be very tight to be effective.

We were taught, if the casualty is not screaming at you, that the tourniquet is too tight, then it is not tight enough*.
*Okay, they do have to be conscious for this metric to work...

 

[Mad Swede]

Medics are are taught to mark on a person's forehead if they have a tourniquet and what time it was put in place, so that when the wounded soldier reaches a field hospital they'll know what the situation is immediately.

You don't just mark them if they have a tourniquet on, you write every injury you've found, what you've done or given them (and when) on them somewhere. All soldiers (at least here in Sweden) are taught to do this, which means that casualties can turn up with an arm or leg (or even shaved head) covered in writing...

 

[Mad Swede]

We were taught, if the casualty is not screaming at you, that the tourniquet is too tight, then it is not tight enough*.
*Okay, they do have to be conscious for this metric to work...

Thats true when you're training. But when you do it for real you realise that the casualty is usually either already in so much pain or so reduced in consciousness from shock and blood loss (or, sometimes, both) that they don't notice how tight the tourniquet is. So you judge tightness by how much the bleeding is reduced.

 

[Karlin]

You don't just mark them if they have a tourniquet on, you write every injury you've found, what you've done or given them (and when) on them somewhere. All soldiers (at least here in Sweden) are taught to do this, which means that casualties can turn up with an arm or leg (or even shaved head) covered in writing...

Here, In Israel, we plain soldiers were taught how to place a tourniquet, but only to write the initials (in Hebrew) that indicate a tourniquet and the time in 24 hour notation.

 

[Selena]

Thanks to all of you this has been very helpful!

 

[Chuck]

Paramedic here.

Tourniquets used to be thought of as a last resort and that using one would result in the loss of the limb. That is not necessarily the case. A proper tourniquet should be a wide band, at least an inch. If it is too narrow, it will cause tissue damage. You wrap the tourniquet around the wound, then use a windlass to tighten it. You tighten it until you stop the bleeding. They don't need to start screaming. As long as the bleeding is controlled, it is tight enough. If the injury is severe enough, you might need to make it tight enough to make them scream, and even add a second one.

If they will end up keeping the limb depends on how bad the injury is and how quickly they can get proper medical attention. A single gun shot wound might require a tourniquet, but not cause enough damage to destroy the limb. They can stay on for a few hours without causing harm, but surgery would be needed as soon as possible to repair the wound. I've seen several people who had to have tourniquets applied and they kept the limb.