Procedure 46 — Wound Care: Tourniquet CAT

What is the first clinical indication for C-A-T tourniquet use?

Life threatening extremity hemorrhage that cannot be controlled by other means.

What is the second clinical indication for C-A-T tourniquet use?

Serious or life threatening extremity hemorrhage where tactical considerations prevent the use of standard hemorrhage control techniques.

What is the third clinical indication for C-A-T tourniquet use?

Partial or complete amputation where resuscitative efforts may restore bleeding.

What is the recommended carrying configuration for the C-A-T tourniquet?

The one-handed configuration.

How is the wounded extremity initially placed for C-A-T tourniquet application?

Through the loop of the Self-Adhering Band.

What is done to the Self-Adhering Band after inserting the extremity?

Pull it tight and securely fasten it back on itself.

How far should the Self-Adhering Band be adhered around the arm?

Not past the Windlass Clip.

What is done with the Windlass Rod to control bleeding?

Twist it until bright red bleeding has stopped.

What locks the Windlass Rod in place once bleeding is controlled?

The Windlass Clip.

What must always be done before moving a patient with a C-A-T tourniquet applied, for added security?

Secure the Windlass Rod with the Windlass Strap.

For small extremities, what additional step secures the C-A-T tourniquet?

Also secure the Self-Adhering Band under the Windlass Strap.

What is done to the band over the rod to finish securing the C-A-T tourniquet?

Adhere the band over the rod.

How is the rod and band secured with the strap in the final step?

By adhering it to the opposite hook on the Windlass Clip.

Where is the C-A-T tourniquet placed relative to the wound?

Proximal to the wound.

What two findings indicate the C-A-T tourniquet is tight enough?

Hemorrhage stops and distal pulses in the affected extremity disappear.

What information about tourniquet application must be written on the tourniquet itself?

The time of application.

Who should be notified of the tourniquet application time?

The receiving care providers.

What protocol governs wound dressing after tourniquet application?

The standard wound care protocol.

What time threshold triggers contacting medical control regarding a C-A-T tourniquet?

Greater than 45 minutes of application time with delayed or prolonged transport.

What guidance is sought from medical control after 45 minutes of tourniquet application?

Guidance on reattempting standard hemorrhage control techniques and removing the tourniquet.

What should be done if one C-A-T tourniquet does not sufficiently control hemorrhage?

Consider applying a second tourniquet more proximal to the first.

What provider level is designated at the "A" tier for C-A-T tourniquet use?

EMT-I.

What other provider levels can apply a C-A-T tourniquet?

EMT-B and EMT-P.