Monitoring a Patient
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Aftercare Following the Use of a Tourniquet or Haemostatic Dressing
Once you have treated a casualty using a tourniquet or haemostatic dressing, your role does not stop there. Ongoing care before the emergency medical services (EMS) arrive is vital and can significantly affect the casualty’s outcome.
Keep the Casualty Warm
One of your most important priorities is to keep the casualty warm.
You can use:
- Foil survival blankets
- A standard blanket
- Double- or triple-layer insulated blankets, such as an igloo blanket
Keeping the casualty warm helps prevent hypothermia. More importantly, cold reduces the body’s ability to clot blood. By maintaining warmth, you directly support the body’s natural clotting process and improve recovery.
Reassure and Calm the Casualty
Talk to the casualty calmly and reassuringly. Your manner and tone of voice can have a significant impact.
- Explain what you are doing
- Offer reassurance
- Encourage them to remain still and relaxed
This helps reduce shock and anxiety. It is just as important that you remain calm. A steady, confident approach reassures both the casualty and anyone assisting you.
Get Help From Others If Needed
If there are people nearby, ask for assistance where appropriate. They can help with:
- Fetching blankets or equipment
- Calling or updating emergency services
- Helping to keep the casualty warm and still
Record the Time of Application
It is essential to record the exact time that a tourniquet or haemostatic dressing was applied.
This information is critical for hospital staff, as it directly affects ongoing treatment decisions.
- Write the time clearly on the casualty (for example, on the skin or clothing)
- Or make a clear note and pass this information directly to EMS on arrival
For example, knowing that a tourniquet has been in place for one hour will guide hospital management.
Label Haemostatic Dressings
If you have used a haemostatic dressing (such as WoundClot), keep the empty packet.
Tuck the empty packet underneath the dressing so it is clearly visible. This allows hospital staff to:
- Identify exactly what product was used
- Plan appropriate follow-up treatment
Anticipate and Manage Shock
You should always expect shock following severe bleeding, even if the casualty does not show immediate signs.
To reduce the risk of shock:
- Keep the casualty lying down
- Do not allow them to stand or sit upright
- If shock develops, raise the legs if appropriate
Ongoing Monitoring
Continue to monitor the casualty closely until help arrives.
Watch for changes in:
- Breathing
- Pulse
- Level of responsiveness
- Skin colour and temperature
Treat what you see. If the casualty’s condition changes, respond accordingly and update emergency services if needed.
Handover to Emergency Services
When the emergency medical services arrive, provide a clear and structured handover.
This should include:
- What happened
- The injuries identified
- Treatments given (tourniquets, haemostatic dressings, pressure)
- Times of application
- The casualty’s response to treatment
- Any relevant medical information
- Any requests made by the casualty, such as contacting family
Key Points to Remember
- Keep the casualty warm to support clotting
- Reassure them and reduce anxiety
- Record and communicate treatment times
- Expect and manage shock
- Monitor continuously until help arrives
- Provide a full handover to EMS
Good aftercare can be just as life-saving as the initial bleeding control.
- IPOSi Unit three LO3.1, 3.2, 3.3 & 3.4
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