Removal of a tourniquet after it has been applied needs to be done carefully. Release of a tourniquet can result in rebleeding or the reperfusion syndrome. King et al listed guidelines for the removal of a tourniquet.
General guidelines for removal of a tourniquet:
(1) A narrow or improvised tourniquet should be replaced with a better tourniquet as soon as possible.
(2) A tourniquet should only be removed by someone with the appropriate medical training.
(3) A tourniquet should not be removed from a patient in shock unless the means to resuscitate the patient are immediately available.
(4) A tourniquet should not be removed if the site cannot be observed for rebleeding.
Time Since Application of the Tourniquet
Recommendation
1-2 hours
Loosen the tourniquet once to determine if rebleeding occurs and if there is continued need for the tourniquet (exception: amputated limb)
2 hours
Usual time limit for an operative tourniquet.
2 - 6 hours
The tourniquet should only be removed if a trained physician decides that the benefit outweighs the risk.
>= 6 hours
Do not remove the tourniquet. Amputation of the limb will probably be necessary.
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