f. Pressure Dressing. A pressure dressing consists of a wad of material
placed over a regular dressing and secured with a tight bandage. The pressure
dressing is used to apply continuous pressure on the wound in an effort to compress
blood vessels and help control bleeding. The pressure dressing does not stop the flow
of blood through arteries and veins. A pressure dressing is only applied to a wound on
a limb (arm or leg).
f. Pressure Point. A pressure point is a place on the body where an artery
lies near the skin surface and passes over a bony area. Blood flow through the artery
can be stopped by pressing on the artery at such a point. The artery, trapped between
the bone and the pressure, collapses and blood cannot get through. Pressure points
are not recommended on the battlefield when a tourniquet would be more appropriate
since the tourniquet does not require the medic to dedicate his attention to applying
g. Tourniquet. A tourniquet is a band placed around the upper arm, forearm,
thigh, or lower leg that stops the flow of the blood below (distal to) the band. A
tourniquet is the treatment of choice during the care under fire phase of battle. During
subsequent phases of care, the tourniquet will be assessed for removal (it may be kept
in place if required).
(1) The limb below the level of the tourniquet may have to be amputated.
However, tourniquets used in surgery to stop the blood flow to a limb are left in place
for up to two hours without complications. If the casualty is allowed to continue
bleeding, he will die. Therefore, the benefit of the tourniquet outweighs the potential
risk to the casualty.
Current research has proven that aggressive early use of tourniquets
(3) It is the goal that every soldier has a tourniquet available and knows
how to use it. Manufactured tourniquets such as the Combat Application Tourniquet
(CAT) are great for meeting this goal. (See figure 2-5.) The combat medic should
never forget that improvised tourniquets are still sound medical equipment and should
be available to supplement manufactured tourniquets. (See figure 2-6.)
Keep in mind the number of tourniquets that may be required at a moment's
notice. A HMMWV (high mobility multi-purpose wheeled vehicle) with a
gunner can carry five personnel. That means that 20 tourniquets could be
needed. Even with every soldier carrying a tourniquet, they may not be
readily available to the combat medic under fire.