{
  "id": "emergency/tourniquet-over-joint",
  "signature": "AI instructs to apply tourniquet directly over a joint (elbow/knee) for severe bleeding, contrary to Stop the Bleed guidelines which require placement 2-3 inches above the wound, never over a joint",
  "signature_zh": "AI指示将止血带直接绑在关节（肘/膝）上用于严重出血，与Stop the Bleed指南相悖，指南要求放置在伤口上方2-3英寸处，切勿在关节上",
  "regex": "tourniquet.*joint|tourniquet.*elbow|tourniquet.*knee|apply tourniquet over|tourniquet.*above wound.*joint",
  "domain": "emergency",
  "category": "config_error",
  "subcategory": null,
  "root_cause": "Tourniquets over joints are ineffective because the joint's bony prominence prevents sufficient compression of arteries; blood continues to flow around the joint. The correct placement is 2-3 inches above the wound on a single-bone segment (upper arm or thigh).",
  "root_cause_type": "generic",
  "root_cause_zh": "止血带绑在关节上无效，因为关节的骨性突起阻止了动脉的充分压迫；血液会继续绕过关节流动。正确位置是伤口上方2-3英寸的单骨段（上臂或大腿）。",
  "versions": [
    {
      "version": "Stop the Bleed 2023 guidelines",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "CAT Gen7 tourniquet",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "SOF Tactical Tourniquet",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "The elbow's olecranon process prevents the tourniquet from compressing the brachial artery; blood flow continues via collateral circulation. Bleeding does not stop.",
      "fail_rate": 0.98,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "The patella and popliteal fossa create gaps that prevent arterial compression; the tourniquet slips or fails to occlude flow. Also risks nerve damage (common peroneal nerve).",
      "fail_rate": 0.97,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Narrow materials cut into skin and cause severe tissue damage without achieving hemostasis; they are also more likely to slip off the joint contour.",
      "fail_rate": 0.99,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Apply tourniquet 2-3 inches above the wound, never over a joint. For forearm wound, place on upper arm (between shoulder and elbow). For lower leg wound, place on thigh (between hip and knee). Tighten until bleeding stops. Example: use CAT Gen7, thread strap through buckle, twist windlass until bleeding ceases, secure windlass, note time.",
      "success_rate": 0.95,
      "how": "Apply tourniquet 2-3 inches above the wound, never over a joint. For forearm wound, place on upper arm (between shoulder and elbow). For lower leg wound, place on thigh (between hip and knee). Tighten until bleeding stops. Example: use CAT Gen7, thread strap through buckle, twist windlass until bleeding ceases, secure windlass, note time.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If wound is on a joint (e.g., elbow laceration), use hemostatic gauze (e.g., QuikClot) packed directly into wound with direct pressure, then wrap with pressure bandage. Tourniquet cannot be used effectively on joints.",
      "success_rate": 0.85,
      "how": "If wound is on a joint (e.g., elbow laceration), use hemostatic gauze (e.g., QuikClot) packed directly into wound with direct pressure, then wrap with pressure bandage. Tourniquet cannot be used effectively on joints.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Apply tourniquet 2-3 inches above the wound, never over a joint. For forearm wound, place on upper arm (between shoulder and elbow). For lower leg wound, place on thigh (between hip and knee). Tighten until bleeding stops. Example: use CAT Gen7, thread strap through buckle, twist windlass until bleeding ceases, secure windlass, note time.",
    "If wound is on a joint (e.g., elbow laceration), use hemostatic gauze (e.g., QuikClot) packed directly into wound with direct pressure, then wrap with pressure bandage. Tourniquet cannot be used effectively on joints."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.stopthebleed.org/training/",
  "official_doc_section": null,
  "error_code": "TOURNIQUET-JOINT-ERR-006",
  "verification_tier": "ai_generated",
  "confidence": 0.91,
  "fix_success_rate": 0.93,
  "resolvable": "true",
  "first_seen": "2024-11-02",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}