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Assessing the tourniquet's efficacy involves checking for cessation of bleeding and the presence of a distal pulse.
If bleeding persists and a distal pulse is still present, further action is required.
Firstly, verify that the tourniquet is sufficiently tight; additional pressure may be necessary for effectiveness.
Remember, significant force is required during tourniquet application to achieve hemostasis.
If the initial tourniquet is correctly applied but ineffective, alternative measures must be considered.
Choices include applying direct pressure, using a hemostatic dressing, or applying an additional tourniquet.
Initially, consider employing direct pressure and a pressure dressing, especially if prior attempts were unsuccessful.
With the tourniquet in place, reduced blood pressure may improve the efficacy of direct pressure and dressing.
Alternatively, the use of a hemostatic dressing or applying another tourniquet presents viable options.
Due to limited guidance, the choice between hemostatic dressing and additional tourniquet relies on the caregiver's judgment.
In the absence of commercial options, improvising a tourniquet may be necessary, prioritizing patient safety.
If multiple tourniquets are required, apply them above or below the initial one, maintaining a 5cm distance from joints.
Consider applying additional tourniquets to the lower limbs, where reduced blood pressure may enhance effectiveness.
Record the time of each tourniquet application and refrain from removing any tourniquet.
In extreme cases, a third tourniquet may be necessary, although uncommon.