Written by DAN Staff

Thanks to the dive industry’s high-quality training and attention to risk management, serious injuries while diving are few and far between. However, the hazards of the marine environment do make life-threatening injuries possible and as a dive professional, you may be one of the first people on the scene and the best equipped to provide first aid.

You’ve been trained to deal with dive injuries, but facing a real-world situation involving major trauma is challenging even for the most experienced medical professionals. When dealing with large wounds that involve profuse bleeding, such as those caused by propellers or serious falls, a tourniquet is one of the best tools you can have to prevent life-threatening blood loss. Brush up on your tourniquet knowledge now so you’ll be ready when the opportunity to make a difference presents itself.

Tourniquet Use

Tourniquets are simple emergency devices that you likely already have in your first aid kit. There are a few popular models, but all are designed to apply pressure to an extremity to limit blood loss. While tourniquets are extremely effective and can be applied rapidly, inappropriate use can result in a failure to prevent blood loss or even significant additional tissue damage and injury.

Tourniquets are:

    • Designed for wounds on the arms or legs
    • Not suitable for wounds on the head, neck or torso.
    • Not designed for use with minor injuries due to the potential for tissue damage, pain and complications.

They should be used in cases of potentially life-threatening bleeding characterized by spurting or pulsing flow of bright red blood (indicating arterial bleeding) or significant and steady flow that is dark red in color (indicating venous bleeding). In both of these situations the risk to the injured person from loss of blood outweighs the potential hazards posed by tourniquet use.

Applying a Tourniquet

Specific deployment steps are determined by your tourniquet’s design, but the general process includes site preparation, application, band tightening and locking the device in place. Be sure to become familiar with the use of the tourniquet that you have in your kit.

    • After identifying an injury that may warrant application of a tourniquet, activate emergency medical services as soon as it’s practical to do so. Attempting to control heavy bleeding may take precedence over calling EMS.
    • Begin by applying direct and firm pressure to the wound to attempt to staunch the flow of blood. If this is successful, there is no need to apply a tourniquet.
    • If it is not practical to apply direct pressure to a wound site due to deteriorating patient condition, loss of scene safety or inaccessibility of the wound, or if direct pressure is ineffective in diminishing blood flow, application of a tourniquet is indicated, provided there is a suitable location on the affected appendage.
    • Reveal the application site by cutting or removing clothing so the tourniquet can be applied to bare skin.
    • Place the device approximately 5 centimetres/2 inches above the wound so that the tourniquet is placed between the torso and the injury. If the wound is below but very close to the knee or elbow, place the tourniquet just above that knee or elbow. If the injury site can’t be identified or there are multiple injury sites, place the tourniquet as high on the injured limb as necessary.

    • If applicable, the ends of the band should then be secured, and the tourniquet should be tightened using the windlass, handle, rod or stick until bleeding has stopped.
    • Once tightened, lock the tourniquet in place and note the time of application. One technique is to write the time on the patient’s forehead using a pen or permanent marker.
    • If bleeding restarts, the tourniquet may be further tightened, but it should never be removed except by a medical professional. Once successfully applied the tourniquet and the injured person should be monitored continually.

Address any other serious injuries and ensure prompt transport to advanced medical care. Any person who sustains injuries significant enough to warrant the use of a tourniquet should be evacuated quickly to prevent loss of the limb and continually monitored for signs of shock or worsening condition until in the care of qualified medical professionals.

For more information about first aid for diving injuries, visit DAN.org/Health.

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