Tourniquets HURT, even if applied correctly.
1.) How do you handle a patient that loosens/removes their tourniquet due to pain? This is common, especially with our host nation partners that don’t understand what we are doing, and even our guys do it, too. (You keep a tourniquet on for 30-45+ minutes and see how you like it.)
2.) How can you differentiate between the pain of a properly applied tourniquet and the pain associated with tourniquet-induced compartment syndrome? What is hallmark about the pain of compartment syndrome?
3.) What are the 6 P’s of compartment syndrome? Every medic should know their 6 P’s.
These are good curveballs to throw at medics and TCCC students during classes, because patients may loosen tourniquets due to pain or it may even physiologically loosen over time even if properly applied; Re-assess, Re-assess, Re-assess.
This is why it is important during classes to have medics/TCCC tighten their tourniquets until total arterial occlusion, not just “half way do it” to go through the motions, because the operator needs to know how much it truly takes, their patients reaction to the TQ, and the “roleplayer patient” can also feel what its like to have a tourniquet on. I recommend not letting the medic “administratively loosen” the TQ himself, but instead have the grader do it. That way it does not effect their muscle memory or cause them to hesitate with real tourniquet use. Have your students prove to you they can perform the action correctly first.