{
  "id": "emergency/tourniquet-on-joint",
  "signature": "AI instructs to apply tourniquet directly over a joint (elbow/knee) for severe bleeding, contrary to Stop the Bleed guidelines",
  "signature_zh": "AI指示在关节（肘/膝）上直接应用止血带以控制严重出血，违反Stop the Bleed指南",
  "regex": "tourniquet.*(?:on|over).*(?:joint|elbow|knee)",
  "domain": "emergency",
  "category": "life_safety",
  "subcategory": null,
  "root_cause": "Tourniquets must be placed 2-3 inches proximal to the wound, never directly over a joint, as joint anatomy prevents effective compression and risks nerve/vascular damage.",
  "root_cause_type": "generic",
  "root_cause_zh": "止血带必须放置在伤口近端2-3英寸处，绝不能直接放在关节上，因为关节解剖结构妨碍有效压迫并可能损伤神经/血管。",
  "versions": [
    {
      "version": "Stop the Bleed v2.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "TCCC Guidelines 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Apply tourniquet directly over the bleeding joint to stop blood flow at the injury site",
      "why_fails": "Joint movement and irregular bone structure prevent adequate compression; tourniquet may slip or fail to occlude artery.",
      "fail_rate": 0.95,
      "condition": "",
      "sources": []
    },
    {
      "action": "Place tourniquet below the joint to avoid interfering with joint function",
      "why_fails": "Venous and arterial flow may not be fully occluded; bleeding from proximal wound may continue.",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "Use a wide bandage instead of a tourniquet for joint bleeds",
      "why_fails": "Direct pressure alone is insufficient for arterial bleeding from joint; tourniquet is indicated for life-threatening hemorrhage.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Place tourniquet 2-3 inches proximal to the wound, above the joint if possible. For elbow bleeds, apply to upper arm; for knee bleeds, apply to upper thigh. Tighten until bleeding stops. Document time of application.",
      "success_rate": 0.9,
      "how": "Place tourniquet 2-3 inches proximal to the wound, above the joint if possible. For elbow bleeds, apply to upper arm; for knee bleeds, apply to upper thigh. Tighten until bleeding stops. Document time of application.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If tourniquet cannot be placed proximal to joint (e.g., wound at joint itself), use hemostatic gauze with direct pressure and consider junctional tourniquet device (e.g., SAM Junctional) if available.",
      "success_rate": 0.75,
      "how": "If tourniquet cannot be placed proximal to joint (e.g., wound at joint itself), use hemostatic gauze with direct pressure and consider junctional tourniquet device (e.g., SAM Junctional) if available.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Place tourniquet 2-3 inches proximal to the wound, above the joint if possible. For elbow bleeds, apply to upper arm; for knee bleeds, apply to upper thigh. Tighten until bleeding stops. Document time of application.",
    "If tourniquet cannot be placed proximal to joint (e.g., wound at joint itself), use hemostatic gauze with direct pressure and consider junctional tourniquet device (e.g., SAM Junctional) if available."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.stopthebleed.org/tourniquet-placement/",
  "official_doc_section": null,
  "error_code": "TQ-JOINT-ERR-001",
  "verification_tier": "ai_generated",
  "confidence": 0.88,
  "fix_success_rate": 0.85,
  "resolvable": "true",
  "first_seen": "2024-03-15",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}