2. There must be a pad to make the pressure over the artery greater than on the rest of the limb—a smooth stone, a darning ball, a large cork, cloth folded into a large pad or a rolled bandage.
3. The pad must be so placed that the artery lies between pad and the bone on the limb, in order that the pressure may stop the flow of blood by forcing the walls of the artery together between the pad and the bone.
4. Unless the tourniquet is put on tight enough, its application increases bleeding. It is extremely rare to find a tourniquet put on tight enough. In almost every such case removing the tourniquet will stop or partly lessen bleeding. A short stick or handle is needed, about a foot long, with which to twist the tourniquet sufficiently to stop the flow of blood. Usually it cannot be twisted tightly enough by hand alone. Tie the twisted part firmly so it will not slip, after it has been made tight enough to stop bleeding.
5. Remember, a tourniquet stops most of the circulation below it as well as in the cut artery, and must not be left in place too long for fear of injury to the rest of the limb by cutting off the circulation. Usually it should not be left on for more than an hour.
Bleeding from Veins—Bleeding from the veins is not so dangerous as from an artery. The blood from the heart has to go through the little capillaries before it gets into the veins, and therefore the force of the heart muscle on the blood in the veins is not so great as in the arteries. The blood does not spurt out, but flows out as it would from a bottle tipped on its side.
You have already learned what to do to stop the bleeding from the smaller veins, and that it is not serious. From the larger veins, however, it can be very serious, and it may be necessary for you to put on a tourniquet before the doctor arrives in order to save the patient's life.
Almost always bleeding from a vein can be controlled by clean gauze or handkerchief pad and pressure by hand directly over the bleeding wound. Tourniquets are almost never needed in bleeding from a vein. If necessary, it is wisest to apply them in the same way as for arterial hemorrhage and stop the circulation in the whole limb.
It is important to know in a general way where the blood vessels are in order to put the pad over them to stop the bleeding. Roughly speaking, the artery of the arm runs down about in a line with the inner seam of the coat. The large vein lies close beside it, carrying the blood back to the heart. The artery and vein of the leg run about in a line with the inside seam of a man's trousers.
Stimulants—In serious bleeding of any kind do not give stimulants until the bleeding has been stopped, as the stimulants increase the force of the heart and so increase the flow of blood. After the tourniquet is on and bleeding is stopped, if the patient is very weak, he may have a teaspoonful of aromatic spirits of ammonia in half a glass of water.
(a) SHOCKS; (b) APOPLEXY; (c) CONVULSIONS