Badly bleeding patients owe lives to return to tourniquets

An orange tourniquet frames Dr Tony Smith (L) and Joe Sigley. Photo / Sarah Ivey

Joe Sigley was bleeding to death after he fell through a window and sliced through an artery in his elbow.

He was walking up the stairs at his Grey Lynn, Auckland, home on December 5 when he tripped and put his arm through the window, causing him to lose nearly three-quarters of his blood.

"My first reaction was to put a hand up and brace myself and my hand went straight through it. On the way out it must have sliced it on the jagged edge and it just started spitting blood."

Ambulance officers found him pale, losing consciousness and dying after severing his brachial artery.

St John medical director Dr Tony Smith is in little doubt what saved Mr Sigley's life - a tourniquet that St John introduced in late 2009.

St John is the first ambulance service in Australasia to bring back tourniquets commonly used in the 1940s and 50s.

They fell from favour because many were not tight enough and did patients more harm than good.

Tourniquets are used to control life- threatening bleeding from a limb that cannot be stopped by normal measures such as applying pressure.

Dr Smith said that if they were not applied tightly enough, venous blood was stopped leaving the limb but arterial blood could still enter, which could make it "much worse".

"But in pre-hospital care, like in ambulances, we continued to see patients with life-threatening bleeding from their limbs that couldn't be controlled by normal means like pushing hard."

St John looked at military experience on battlefields in Iraq and Afghanistan, where tourniquets applied properly save lives.

"We've had them in place since the end of 2009 and we're starting to see a series of patients, of which Joe is one, where we are confident it has made a substantial contribution to saving their life."

Several patients, like Mr Sigley, would have been dead by the time they arrived at hospital.

Dr Smith said he was already showing signs of "massive blood loss".

"Even with intense pressure, officers couldn't stop the bleeding. He'd lost about three-quarters of the blood in his body by the time we got to him. He was almost dead. We couldn't control the bleeding so we put on a tourniquet and it stopped instantly."

However, Dr Smith urged caution. "For the public we'd say push hard on the bleeding, very hard, elevate bleeding if you can and call an ambulance."

His advice was not to use tourniquets unless told to by a doctor or ambulance officer.

Mr Sigley said his girlfriend, Mahia, put her knee into his shoulder to try to cut the circulation after he fell through the window.

He was not in too much pain but he knew when he saw how much blood there was that he was in trouble.

"I'd lost 2 litres of blood and when they put the tourniquet on I could hear them saying, 'It's stopped bleeding'.'

The 24-year-old thought he would die. "I really did. I kept saying to the ambos, 'I think I'm gone here, mate', but they were so calm, dead calm, saying, 'You'll be right, mate, there's nothing wrong with your arm'."

The wound is healing well but the feeling has not returned to Mr Sigley's fingers yet. The scar will not be as bad as he first feared.

He has had surgery to rejoin the artery and plastic surgery to repair the tendons.