# 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

- **ID:** `emergency/tourniquet-over-joint`
- **领域:** emergency
- **类别:** config_error
- **错误码:** `TOURNIQUET-JOINT-ERR-006`
- **验证级别:** ai_generated
- **修复率:** 93%

## 根因

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）。

## 版本兼容性

| 版本 | 状态 | 引入 | 弃用 |
|------|------|------|------|
| Stop the Bleed 2023 guidelines | active | — | — |
| CAT Gen7 tourniquet | active | — | — |
| SOF Tactical Tourniquet | active | — | — |

## 解决方案

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

## 无效尝试

- **** — The elbow's olecranon process prevents the tourniquet from compressing the brachial artery; blood flow continues via collateral circulation. Bleeding does not stop. (98% 失败率)
- **** — 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). (97% 失败率)
- **** — Narrow materials cut into skin and cause severe tissue damage without achieving hemostasis; they are also more likely to slip off the joint contour. (99% 失败率)