TOURNIQUETS in General Match Issues Posted Wednesday at 06:08 PM Every few years the American College of Surgeons comes out with a SESAP program for surgeons. This stands for Self Education Self-Assessment Program, and it an intensive course covering a multitude of topics encountered by a General Surgeon. The topic of tourniquets came up. This is from the American College of Surgeons: The purpose of the tourniquet is to stop arterial inflow and prevent ongoing hemorrhage. Inappropriately applied, tourniquets may actually increase bleeding due to inadequate arterial occlusion and increased venous congestion. A concern with the use of tourniquets is nerve and muscle injury. Appropriate application and removal of tourniquets is not associated with muscle and nerve damage but does reduce deaths from bleeding. The principles of the proper application of tourniquets include the following: · Only use tourniquets for potentially life-threatening extremity bleeding. · Set the tourniquet at the lowest possible pressure needed to effectively stop hemorrhage. · Place the tourniquet as close to the wound as possible. · Keep meticulous tourniquet time, because tourniquet time should be minimized, ideally not exceeding 2 hours. · Use side-by-side or wide tourniquets to minimize tissue damage and for large wounds. Once at the hospital, the tourniquet should be released only in a controlled setting such as an operating room. Tourniquet use is not associated with increased limb loss.