Should Tourniquets Be Included in Workplace First Aid?

Companies should strongly consider adding tourniquets to current first aid supplies.  This is a ‘recent’ change to thinking.  I clearly remember my instructors back when I took my EMT-Basic course in the early 90’s telling us: “tourniquets are a last resort, and you’ll probably never need one”.  Things have changed substantially as we learn more about rapid trauma care.

In my training, we were taught to release it every 15 minutes in order to keep from losing the limb.  Well all that has changed in the last 25 years; now you leave them on until you reach a more advanced level of care.  

So, what do we need to understand about the trauma care guidelines and tourniquets?

Life threatening bleeding can occur from a number of workplace exposures.  Equipment incidents, vehicle crashes, entanglement injuries, natural disasters, or workplace violence are all possible sources of severe trauma. Uncontrolled bleeding can result in death within minutes – even before emergency medical services or other emergency responders can arrive. These first minutes following a traumatic injury are crucial in saving a life.

Today, tourniquets are widely used by EMS, law enforcement and lay responders and have a proven track record of saving lives. The wide use of tourniquets began in the US military when they realized they had the best advanced medical care in the world, but victims didn’t live long enough to benefit from that care.

“90% of combat deaths occur on the battlefield before the casualty ever reaches a medical treatment facility.”

-Col. Ron Bellamy

In recent years, the US military has done extensive testing on the treatment of wounds in the field.  This has resulted in the development of new individual first aid kits or IFAKs.  Currently there are only two tourniquets that are approved to be used in these kits. These are the North American Rescue CAT or combat application tourniquet and the SOFTT tourniquet.  Both are similar in style and consist of a strap and buckle with a windlass to tighten it.

Pre-hospital application of a tourniquet

C-A-T Tourniquet photo

What do I put in my first aid kit?

A wide variety of injuries might require first aid, and OSHA does not have strict requirements for the materials a first aid kit should contain. Instead, the agency advises in its Best Practices Guide: Fundamentals of a Workplace First-Aid Program, that each employer designate one person the responsibility of choosing the types and amounts of first aid supplies, as well as maintaining them and the kit. As a starting point, OSHA directs employers to American National Standard ANSI/ISEA Z308.1-2015, “Minimum Requirements for Workplace First-aid Kits,” which recommends the following contents:

  • Adhesive bandage
  • Adhesive tape
  • Antibiotic application
  • Antiseptic
  • Breathing barrier
  • Burn dressing (gel soaked)
  • Burn treatment
  • Cold pack
  • Eye covering (with means of attachment)
  • Eye/skin wash
  • First aid guide
  • Hand sanitizer
  • Medical exam gloves
  • Roller bandage (2 inch)
  • Roller bandage (4 inch)
  • Scissors
  • Splint
  • Sterile pad
  • Tourniquet
  • Trauma pad
  • Triangular bandage

As we review this list, tourniquets stand out from the rest.  Adhesive bandages aren’t used for immediate life saving efforts. They are more comfort and infection protection than anything. Tourniquets, CPR supplies, and AEDs are immediate life saving devices and should be given serious consideration in every workplace first aid kit.

At Riskill, our training content is constantly updated to meet today’s current standards. We offer first aid training that includes hands-on training with tourniquets, including the background, application, and care for serious trauma.  While our primary efforts help companies prevent these type of incidents, we can help get your organization ready for the worst.

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