Page 12 - Journal of Special Operations Medicine - Fall 2015

(Continued from page i)

ne of the most important tools in the medic’s arma- In the 1300s, French surgeon Guy de
Omentarium is the tourniquet. Although it has be- Chauliac was known for wrapping a
come standard equipment, recently as the early 2000s, tight band below and above the site
the tourniquet was still enmeshed in a longstanding con- of amputation to cut down on hem-
troversy about whether they were more trouble than they orrhage. In the 1500s, Botallo taught
were worth. 1 that one should apply three tight bands
and perform amputation between the
“Some people saw them as lifesaving, and others said lower two. In 1593, Fabricius used a
they were the instrument of the devil,” said COL (Ret) stick to tighten the tourniquet above
1
John F. Kragh Jr, MD, an orthopedic surgeon with the the amputation site. In the late 1660s,
US Army Institute of Surgical Research and a renowned Scultetus used a screw compressor.
expert on tourniquets. By 1718, Petit was using a screw de-
vice that allowed for tightening and compression (right,
“Although tourniquets have been used to stem blood Wikipedia). Throughout history, a variety of tourniquet
loss since at least the time of the Roman Empire, mod- designs have been used, leading to the highly researched
ern military surgeons had grown to doubt it. There were and effective devices in use today. (Bottom) Tourniquets
no good studies proving their benefit. And there was from Roman times to the early 1900s. All reprinted with
a common belief that some tourniquets could do more permission from Wellcome Library, London.
harm than good, cutting off blood and oxygen to limbs
and resulting in amputations.” 1 In This Issue, Dr Kragh, an Associate Editor of the
JSOM, and his colleagues have provided an article titled
“There are a number of ways to mess it up,” said Kragh, “Junctional Tourniquet Training Experience,” starting
who is a leading researcher on methods to control bleed- on page 20.
ing. Sometimes tourniquets were not tight enough, caus-
ing bleeding to actually get worse. Some were not wide The work that Dr Kragh and his associates perform en-
enough. sures that our readers are able to provide the most up-
to-date care and save lives.
1. Stobbe M. Once-doubted tourniquet seen as Boston life-saver. http://
www.nbcnewyork.com/news/national-international/NATL-Once
-Doubted-Tourniquet-Seen-as-Boston-lifesaver--203650721.html.

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