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NC adds tourniquets to EMS treatment protocols
By Jeff Hampton
PASQUOTANK COUNTY, N.C — Pasquotank County paramedic Jack Boyce slipped a manufactured tourniquet on his arm, pulled the strap tight and twisted the plastic crank until blood vessels bulged from his wrist.
The demonstration was done in seconds.
Shunned in the past, the mechanical tourniquets proved to be life savers with few side effects after the Sept. 11 attacks and in the Iraq war.
On April 1, Pasquotank and Camden counties will stock ambulances for the first time with the manufactured tourniquets.
Tourniquets will remain a last resort, but life-threatening arterial bleeding from vehicle and aircraft crashes and accidents with farm equipment or chain saws are always possible, said Jerry Newell, director of the Pasquotank-Camden Emergency Medical Service.
"We've got the potential around here," he said. "If you're putting this on somebody, it's life or death. They're bleeding out."
Tourniquets are part of 58 new training and treatment protocols required by North Carolina's Office of Emergency Medical Services to be in place by April 1.
"We wanted to standardize treatment statewide," said Drexdal Pratt, chief of the agency.
Statewide protocols were put in place in 2000 and have been updated regularly. This is the first time tourniquets were included, Pratt said.
"There has been better evidence that appropriate tourniquet use is less detrimental to distal tissue than previously thought," Mears said, "especially when used in a more controlled setting with better equipment and better tourniquet pressure control."
Successful treatment of blast injuries after Sept. 11 and in Iraq have promoted the use of tourniquets, he said.
"It is now being taught in these preparedness courses," Mears said.
New tourniquets purchased for local ambulances have a padded U-shaped band that fits over the appendage while a strap cinches around the other side through a clasp. A plastic half-circle can be cranked, tightening the strap until blood flow is stopped. A quick-release button eases tension immediately when needed.
"It takes about 15 seconds," Newell said.
Currituck, Pasquotank and Camden will use also use other treatment upgrades in the protocols, including a continuous positive airway pressure machine, a device that pushes air into the lungs if the patient has quit breathing.
Another new device is the adult intraosseous, or IO, which injects an IV directly into bone marrow and is used only when a blood vessel is inaccessible.
Currituck also plans to use a protocol for aquatic bites, such as putting vinegar on jellyfish stings, typical for counties that border the ocean.
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