# 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

- **ID:** `emergency/tourniquet-on-joint`
- **领域:** emergency
- **类别:** life_safety
- **错误码:** `TQ-JOINT-ERR-001`
- **验证级别:** ai_generated
- **修复率:** 85%

## 根因

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。

## 版本兼容性

| 版本 | 状态 | 引入 | 弃用 |
|------|------|------|------|
| Stop the Bleed v2.0 | active | — | — |
| TCCC Guidelines 2024 | active | — | — |

## 解决方案

1. ```
   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.
   ```
2. ```
   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.
   ```

## 无效尝试

- **Apply tourniquet directly over the bleeding joint to stop blood flow at the injury site** — Joint movement and irregular bone structure prevent adequate compression; tourniquet may slip or fail to occlude artery. (95% 失败率)
- **Place tourniquet below the joint to avoid interfering with joint function** — Venous and arterial flow may not be fully occluded; bleeding from proximal wound may continue. (85% 失败率)
- **Use a wide bandage instead of a tourniquet for joint bleeds** — Direct pressure alone is insufficient for arterial bleeding from joint; tourniquet is indicated for life-threatening hemorrhage. (70% 失败率)