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Tourniquet Application

Critical life-saving procedure for severe extremity hemorrhage control

Emergency Application Timer

Target time: Under 60 seconds from decision to application

0:00
EXCELLENT
1

Step 1: Rapid Assessment

5 seconds

Quickly identify severe extremity bleeding

Actions

  • 1Visually identify source of bleeding
  • 2Assess if bleeding is life-threatening
  • 3Determine if tourniquet is appropriate
  • 4Check for multiple injury sites

Critical Points

  • Don't waste time with pressure points
  • Tourniquets for severe extremity bleeding only
  • If in doubt, apply tourniquet

Common Mistakes to Avoid

Placing tourniquet too low

Critical
Consequence: Ineffective bleeding control
Correction: Place 2-3 inches proximal to wound

Insufficient tightening

Critical
Consequence: Continued bleeding, increased blood loss
Correction: Tighten until all bleeding stops completely

Not securing windlass

High
Consequence: Tourniquet loosens, bleeding resumes
Correction: Properly hook and secure windlass clip

Failure to mark time

High
Consequence: Unknown ischemia time, poor medical decisions
Correction: Always document application time

Removing tourniquet in field

Critical
Consequence: Massive bleeding, shock, death
Correction: Only remove in hospital setting

Quick Reference Steps

Emergency tourniquet application checklist

1
Rapid Assessment
5 seconds
2
Position Tourniquet
10 seconds
3
Apply and Tighten
30 seconds
4
Secure Windlass
15 seconds
5
Mark Time
10 seconds
6
Reassess and Monitor
Ongoing

Tourniquet Types

Common military and tactical tourniquets

Combat Application Tourniquet (CAT)

Excellent
Standard military and tactical use
Advantages:
  • +Self-applicable
  • +One-handed operation
  • +Time-tested
  • +NSN stocked
Disadvantages:
  • -Velcro can fail
  • -Bulky when deployed
  • -Single use

SOF Tactical Tourniquet (SOFTT)

Excellent
Special operations and tactical teams
Advantages:
  • +Quick application
  • +Metal components
  • +Durable construction
  • +Easy to use
Disadvantages:
  • -More expensive
  • -Heavier than CAT
  • -Less common

Tactical Mechanical Tourniquet (TMT)

Good
Hospital and ambulance use
Advantages:
  • +Pneumatic system
  • +Even pressure distribution
  • +Easy application
Disadvantages:
  • -Battery dependent
  • -Complex mechanism
  • -Weather sensitive

Key Reminders

NEVER remove a tourniquet in the field

Only trained medical personnel in hospital settings should remove tourniquets

Time is critical

Document application time immediately and clearly

When in doubt, apply

Better to have an unnecessary tourniquet than lose a life to hemorrhage

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MARCH AlgorithmCombat Triage