Tourniquet (junctional)

Background

  • Junctional tourniquets are devices that allow for proximal compression of arterial bleeding and thus control of junctional hemorrhage
  • Junctional tourniquets (JTQ) were initially cleared by FDA in 2010 for use in pre-hospital medicine
  • Developed because of limitations of traditional extremity tourniquets in controlling hemorrhage between the trunk and limbs. These difficult to access locations were responsible for 20% of preventable deaths by bleeding on the battlefield.
  • Testing has shown JTQ to be 75-100% effect in controlling hemorrhage

Properties of a good junctional tourniquet

  • Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck
  • Compress bleeding from sites where regular TQ cannot be applied
  • Safe to use
  • Effective for prehospital use
  • Small with low profile
  • Lightweight
  • Low-cost
  • Easy to use requiring minimal training
  • Applied quickly
  • Does not slip on tightening when in use
  • Provides easy release of compression
  • Easy to reapply
  • Long shelf life

Indications

  • Junctional hemorrhage not controlled by other means

Contraindications

  • None

Application of Junctional Tourniquet

  • Application varies by tourniquet design (multiple different types of junctional tourniquet exist)
  • Clearly mark tourniquet with time of application

Proper removal in hospital setting

  • Loosen the tourniquet while observing wound for bleeding
  • If wound now hemostatic, leave pressure off
  • If wound continues to bleed, re-apply pressure and prepare for urgent definitive management of bleeding

See Also

References