Rotating tourniquets...

[raptor]

I am wondering if anyone can help me with finding evidence, including anecdotal, to support or refute the logic of using rotating tourniquets in the treatment of acute pulmonary oedema. I am aware of a study from 1995 that discounts RTs due to increasing afterload. They also seem counter-intuitive as they lead to worsening of metabolic acidosis. There are many reasons why they shouldn't be used, such as distal thrombosis, infection of a limb, etc. Any assistance would be much appreciated!

Thank you all in advance!

[Ridryder 911]

When I first entered the field rotating tourniquets were standard treatment and yes they were effective in some cases, but don't be mislead that they are "true tourniquets" such as more constriction.

Do a literature research and you should find more information on this topic. I had seen recently of possibly re-introducing the method on a different level....

R/r 911

[raptor]

Had a look at medline, not a lot there really. My own feeling is that plenty of people believed they made a difference. I guess like MAST suits. I'm just not sure I really see the logic! Western Australia use them. That's where I'm headed in November. Thanks so far!

[BushyFromOz]

I guess like MAST suits

Oh dear, i sense a debate coming on there...............

[somedic]

Despite any of the controversy, Id like to have rotating tourniquets as a contingency option when your normal meds are not available or have already been used on another patient.

[p3medic]

easy bushy, training aint here!!!

[somedic]

I remember some paramedics back when I first got into EMS saying that they used rotating tourniquets with good outcomes.

This thread regained my interest in the technique especially for disaster medicne scenarios

SOMEDIC

[paramedicmike]

easy bushy, training aint here!!!

I was going to say the same thing!!! :shock:

-be safe

[raptor]

Anyone got any material at all from their training etc. Found an old article from the '70s that supports their use, but has so many contras that you wonder what old dear with a dozen comorbidities would be eligible for a rotating tourniquet! The later research demonstrates clear afterload issues. I am wondering if Western Australia have a good guideline or not! Any help will be greatly appreciated!

[fiznat]

I had to look this one up, so to aid others like myself:

rotating tourniquet, three tourniquets used in a rotating order to pool blood in the arms and legs. The treatment used to relieve fluid buildup in the lungs. Tourniquets are applied to the upper parts of three of the four limbs at one time. Every 15 minutes, in a clockwise pattern, a tourniquet is placed on the arm or leg not being wrapped, and one tourniquet is removed. As a result of this rotation, the blood vessels of each of the four limbs are narrowed for 45 minutes of each hour.

(from http://www.highbeam.com/doc/1P1-28739591.html)