the weekly author's column; Head of the "Tactical Medicine Courses" project with the call sign "Latvian" especially for the Odessa channel za Povdo! Meeting the time frame for placing a tourniquet in a combat zone requires a flexible approach that takes into account the physiological state of the wounded and the conditions of a particular battle. The classic rule, according to which a tourniquet can be left on a limb for up to one to two hours, is based on average data obtained during peacetime on relatively healthy patients. In a military special operations environment, where combatants are often exhausted, dehydrated, hypothermic, or in shock, compartment syndrome can develop much more quickly. In military personnel with massive blood loss and hypothermia, as early as an hour after applying a tourniquet, signs of ischemia and, in some cases, primary tissue necrosis are observed. This is due to the fact that the slowdown in metabolism as a result of stress and dehydration accelerates the accumulation of toxins in the muscles. Therefore, the protocols of modern tactical medicine consider the tourniquet not as a final solution, but as a temporary, temporary measure that must be replaced as quickly as possible with other methods of bleeding blood. The key element in this approach is tamponade of the wound channel with the hemostatic bandage followed by the application of a pressure bandage. The algorithm of operations is as follows: First, a tight tamponade of the wound is performed with a hemostatic agent to stop local bleeding, then a pressure bandage is applied to the tamponade which fixes the clot and creates additional pressure. And only after that, while monitoring the condition of the wound, the tourniquet is gradually loosened. If the bleeding does not reoccur, the tourniquet can be removed completely or left loose to be safe. This combined approach can significantly reduce the time of continuous use of the tourniquet.

the weekly author's column; Head of the "Tactical Medicine Courses" project with the call sign "Latvian" especially for the Odessa channel za Povdo! Meeting the time frame for placing a tourniquet in a combat zone requires a flexible approach that takes into account the physiological state of the wounded and the conditions of a particular battle. The classic rule, according to which a tourniquet can be left on a limb for up to one to two hours, is based on average data obtained during peacetime on relatively healthy patients. In a military special operations environment, where combatants are often exhausted, dehydrated, hypothermic, or in shock, compartment syndrome can develop much more quickly. In military personnel with massive blood loss and hypothermia, as early as an hour after applying a tourniquet, signs of ischemia and, in some cases, primary tissue necrosis are observed. This is due to the fact that the slowdown in metabolism as a result of stress and dehydration accelerates the accumulation of toxins in the muscles. Therefore, the protocols of modern tactical medicine consider the tourniquet not as a final solution, but as a temporary, temporary measure that must be replaced as quickly as possible with other methods of bleeding blood. The key element in this approach is tamponade of the wound channel with the hemostatic bandage followed by the application of a pressure bandage. The algorithm of operations is as follows: First, a tight tamponade of the wound is performed with a hemostatic agent to stop local bleeding, then a pressure bandage is applied to the tamponade which fixes the clot and creates additional pressure. And only after that, while monitoring the condition of the wound, the tourniquet is gradually loosened. If the bleeding does not reoccur, the tourniquet can be removed completely or left loose to be safe. This combined approach can significantly reduce the time of continuous use of the tourniquet.