Dilemmas on the use of tourniquet in first aid

Uvod: Dajanje prve pomoči je moralna in pravna dolžnost vsakega prebivalca, slednja mora biti nudena celostno, kar pomeni, da je treba poskrbeti tako za fiziološke kot za psihološke potrebe poškodovane osebe. Kri je življenjsko pomembna tekočina za vsakega izmed nas. Nepravočasno oskrbljene krvavitve spadajo med enega poglavitnih vzrokov za smrt v zunajbolnišničnem okolju. Eden od pomembnih ukrepov pri zaustavljanju hudih krvavitev iz okončin je tudi pravočasna in pravilna namestitev preveze uda. Namen: Ugotoviti želimo, pri katerih poškodbah naj laik namesti prevezo uda in v katerih primerih to ni potrebno ter kakšen je pravilen postopek namestitve preveze uda v prvi pomoči. Metode dela: Pri izdelavi diplomskega dela smo uporabili deskriptivno metodo dela. Slednje vsebuje pregled strokovne in znanstvene literature. Izbrana literatura je v slovenskem in angleškem jeziku. Vire smo pridobili prek portala DiKUL in v podatkovnih bazah PubMed, ScienceDirect, CINAHL in Cochrane Library. Za iskanje slovenske literature smo uporabili COBISS+. Rezultati: Laiki smejo namestiti prevezo uda, kadar krvavitve niso zmožni zaustaviti z direktnim pritiskom na rano, ki se nahaja na udu ali kadar je prisotnih več krvavitev hkrati. Prevezo uda smejo namestiti nad mesto poškodbe, pri tem naj se izognejo namestitvi čez sklep okončine. Prevezo morajo laiki fiksirati na mestu in z vzvodom povzročiti tako močan pritisk, da se prekine krvavitev. Preveze naj ne prekrivajo. Zabeleži naj se čas namestitve. Po uspešno zaustavljeni krvavitvi morajo zagotoviti čim hitrejšo ustrezno medicinsko pomoč. Razprava in zaključek: Vsak laik mora prepoznati zunanjo krvavitev in jo nemudoma zaustaviti, saj lahko slednja privede do šoka ali smrti. Krvavitve iz ran na okončinah spadajo med najbolj pogoste vzroke smrti v civilnem okolju, ki jih je možno preprečiti. Preveza uda pri masovnih nesrečah predstavlja enega ključih dejavnikov za pravočasno zaustavitev krvavitve in posledično preživetje. Vsaka oseba bi morala znati poškodovanca oskrbeti ter mu v čim krajšem možnem času priskrbeti strokovno zdravniško pomoč. Pri tem mora laik poskrbeti za varnost sebe in poškodovanca. Ob tem vseeno ostaja dilema, ali neusposobljen laik zna prepoznati, kdaj je treba postaviti preživetje poškodovanca pred preživetje uda.Introduction: First aid is a moral and legal duty of every resident. Care must be holistic. It is necessary to attend to both the physiological and psychological needs of the injured person. Blood is a vital fluid for each of us. Bleeding that is not stopped on time is one of the leading causes of death outside of the hospital. One of the important measures in stopping severe bleeding from the extremities is also the timely and correct placement of a tourniquet. Purpose: To find out in which injuries a tourniquet should be used and in which cases it is not necessary, as well as the proper procedure for applying a tourniquet in first aid. Methods: We used a descriptive working method. The paper contains a review of the literature. The selected literature is in Slovenian and English. Resources were obtained from DiKUL portal, PubMed, ScienceDirect, CINAHL and Cochrane Library databases. For searching the Slovenian literature, we used COBISS+. Results: A layperson must install a tourniquet when they are not capable to stop the bleeding by applying direct pressure to the wound or when multiple bleeds are present at the same time. A tourniquet should be placed above the wound, avoiding placement over the limb joint. It must be fixed in place by the laity, and the lever must exert such severe pressure as to stop the bleeding. A tourniquet must not be covered. The time of placement needs to be written. After successful cessation of bleeding, they must provide appropriate medical assistance as soon as possible. Discussion and Conclusion: Every layperson must know how to recognize external bleeding and stop it immediately, as it can lead to shock or even death. Bleeding from wounds on the extremities is one of the most common causes of preventable death in civilian settings. The use of a tourniquet in mass casualty incidents is one of the key factors in stopping bleeding on time and survival. Everyone should know how to stop severe bleeding and get professional medical help as soon as possible. They should be able to take care of their safety and the safety of others. However, the dilemma remains whether an untrained layperson can recognize when it is necessary to put the survival of the injured before the survival of the limb