Tourniquet (junctional) - Revision history

Blsimpso at 21:58, 29 June 2021

2021-06-29T21:58:15Z

← Older revision		Revision as of 21:58, 29 June 2021
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	*[[Resuscitative endovascular balloon occlusion of the aorta]]		*[[Resuscitative endovascular balloon occlusion of the aorta]]
	*[[Tourniquet]]		*[[Tourniquet]]

			==External Links==

			===Videos===
			{{#widget:YouTube\|id=1iP0IbO9Gog}}

	==References==		==References==

Rossdonaldson1: /* Properties of a good junctional tourniquet */

2021-05-08T05:39:56Z

Properties of a good junctional tourniquet

← Older revision		Revision as of 05:39, 8 May 2021
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	[[File:PMC5022193 13049 2016 301 Fig5 HTML.png\|thumb\|SAM-JT™.]]		[[File:PMC5022193 13049 2016 301 Fig5 HTML.png\|thumb\|SAM-JT™.]]
	[[File:PMC5022193 13049 2016 301 Fig4 HTML.png\|thumb\|JETT™.]]		[[File:PMC5022193 13049 2016 301 Fig4 HTML.png\|thumb\|JETT™.]]
			[[File:PMC5022193 13049 2016 301 Fig3 HTML.png\|thumb\|AAJT™.]]
	*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck		*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck
	*Compress bleeding from sites where regular TQ cannot be applied		*Compress bleeding from sites where regular TQ cannot be applied

Rossdonaldson1: /* Properties of a good junctional tourniquet */

2021-05-08T05:38:54Z

Properties of a good junctional tourniquet

← Older revision		Revision as of 05:38, 8 May 2021
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	[[File:PMC5022193 13049 2016 301 Fig2 HTML.png\|thumb\|iTClamp™.]]		[[File:PMC5022193 13049 2016 301 Fig2 HTML.png\|thumb\|iTClamp™.]]
	[[File:PMC5022193 13049 2016 301 Fig5 HTML.png\|thumb\|SAM-JT™.]]		[[File:PMC5022193 13049 2016 301 Fig5 HTML.png\|thumb\|SAM-JT™.]]
			[[File:PMC5022193 13049 2016 301 Fig4 HTML.png\|thumb\|JETT™.]]
	*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck		*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck
	*Compress bleeding from sites where regular TQ cannot be applied		*Compress bleeding from sites where regular TQ cannot be applied

Rossdonaldson1: /* Properties of a good junctional tourniquet */

2021-05-08T05:37:43Z

Properties of a good junctional tourniquet

← Older revision		Revision as of 05:37, 8 May 2021
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	==Properties of a good junctional tourniquet==		==Properties of a good junctional tourniquet==
	[[File:PMC5022193 13049 2016 301 Fig2 HTML.png\|thumb\|iTClamp™.]]		[[File:PMC5022193 13049 2016 301 Fig2 HTML.png\|thumb\|iTClamp™.]]
			[[File:PMC5022193 13049 2016 301 Fig5 HTML.png\|thumb\|SAM-JT™.]]
	*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck		*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck
	*Compress bleeding from sites where regular TQ cannot be applied		*Compress bleeding from sites where regular TQ cannot be applied

Rossdonaldson1: /* Properties of a good junctional tourniquet */

2021-05-08T05:35:42Z

Properties of a good junctional tourniquet

← Older revision		Revision as of 05:35, 8 May 2021
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	==Properties of a good junctional tourniquet==		==Properties of a good junctional tourniquet==
			[[File:PMC5022193 13049 2016 301 Fig2 HTML.png\|thumb\|iTClamp™.]]
	*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck		*Stop bleeding effectively from junction areas such as groin, pelvis, shoulder, or neck
	*Compress bleeding from sites where regular TQ cannot be applied		*Compress bleeding from sites where regular TQ cannot be applied

Rossdonaldson1: /* Background */

2021-05-08T05:34:24Z

Background

← Older revision		Revision as of 05:34, 8 May 2021
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	==Background==		==Background==
			[[File:Sobo 1909 573-574.png\|thumb\|Anterior thigh anatomy (right) showing vein medial to artery and nerve.]]
	*Junctional tourniquets are devices that allow for proximal compression of arterial bleeding and thus control of junctional hemorrhage		*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		*Junctional tourniquets (JTQ) were initially cleared by FDA in 2010 for use in pre-hospital medicine

Mholtz at 06:02, 20 February 2018

2018-02-20T06:02:00Z

← Older revision		Revision as of 06:02, 20 February 2018
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	==Background==		==Background==
	* Junctional ~~Tourniquets~~ (JTQ) were initially cleared by FDA in 2010 for use in pre-hospital medicine		*Junctional tourniquets are devices that allow for proximal compression of arterial bleeding and thus control of junctional hemorrhage
	* ~~JTQs were 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.		*Junctional tourniquets (JTQ) were initially cleared by FDA in 2010 for use in pre-hospital medicine
	* ~~JTQs are devices that allow for proximal compression of arterial bleeding and thus control of junctional~~ hemorrhage.		*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.
	* Lethality of junctional hemorrhage is greater because of the large lumen size of injured vessels		*Testing has shown JTQ to be 75-100% effect in controlling hemorrhage

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

	==Indications==		==Indications==
	* Junctional hemorrhage not controlled by ~~pressure dressing~~		*Junctional hemorrhage not controlled by other means
	* Some JTQ can also be used to stabilize suspected pelvic fractures
	* Testing has shown JTQ to be 75-100% effect in controlling hemorrhage

	==Contraindications==		==Contraindications==
	* ~~Not applicable~~		*None
	: ''N.B. there is on the market a truncal tourniquet which has been cleared by the FDA for junctional hemorrhage. This device is contraindicated in pregnancy, abdominal aortic aneurysm, and penetrating abdominal trauma.
	''

	==Application of Tourniquet==		==Application of Junctional Tourniquet==
	* ~~As per manufacturer's guidance~~		*Application varies by tourniquet design (multiple different types of junctional tourniquet exist)
	* ~~Committee on Tactical Combat Casualty Care lists three possible devices~~		*Clearly mark tourniquet with time of application

	==~~Precautions==~~		==Proper removal in hospital setting==
	* Do not remove JTQ which has been in ~~place more than 6 hours~~		*Loosen the tourniquet while observing wound for bleeding
	* Expose and clearly mark all tourniquets with time of application		*If wound now hemostatic, leave pressure off
			*If wound continues to bleed, re-apply pressure and prepare for urgent definitive management of bleeding
	~~==Proper Removal~~==
	* ~~ASAP convert junctional~~ tourniquet ~~to hemostatic pressure dressing if:~~
	** Patient not in shock
	** It is possible to monitor the wound ~~closely~~ for bleeding
	** JTQ is not being used to control bleeding form an amputated extremity or to stabilize a suspected pelvic fracture
	* If ~~bleeding recurs after removal in hospital consider non~~-~~surgical interventions such as direct pelvic packing, vessel ligation, Foley or extravascular balloon tamponade although specific technique will depend on resources~~ and ~~skills available~~

	==See Also==		==See Also==
			*[[Resuscitative endovascular balloon occlusion of the aorta]]
	*[[Tourniquet]]		*[[Tourniquet]]

Rossdonaldson1: /* References */

2018-02-16T06:16:30Z

References

← Older revision		Revision as of 06:16, 16 February 2018
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	** JTQ is not being used to control bleeding form an amputated extremity or to stabilize a suspected pelvic fracture		** JTQ is not being used to control bleeding form an amputated extremity or to stabilize a suspected pelvic fracture
	* If bleeding recurs after removal in hospital consider non-surgical interventions such as direct pelvic packing, vessel ligation, Foley or extravascular balloon tamponade although specific technique will depend on resources and skills available		* If bleeding recurs after removal in hospital consider non-surgical interventions such as direct pelvic packing, vessel ligation, Foley or extravascular balloon tamponade although specific technique will depend on resources and skills available

			==See Also==
			*[[Tourniquet]]

	==References==		==References==
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	[[Category:EMS]]		[[Category:EMS]]
	[[Category:Procedures]]		[[Category:Procedures]]
			[[Category:Trauma]]

Rossdonaldson1: Rossdonaldson1 moved page Tourniquet, junctional to Tourniquet (junctional)

2018-02-16T06:15:58Z

Rossdonaldson1 moved page Tourniquet, junctional to Tourniquet (junctional)

← Older revision	Revision as of 06:15, 16 February 2018
(No difference)

Rossdonaldson1: /* References */

2018-02-16T06:12:25Z

References

← Older revision		Revision as of 06:12, 16 February 2018
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	[[Category:Military]]		[[Category:Military]]
	[[Category:EMS]]		[[Category:EMS]]
			[[Category:Procedures]]