The Essential Guide on the Proper Use of Combat Tourniquets

When to Use a Tourniquet

• Severe, uncontrolled bleeding from an arm or leg.
• In situations where direct pressure or wound packing isn’t possible or effective.
• When medical help is not immediately available.

Step-by-Step Guide to Applying a Tourniquet:

1. Safety First:
   • Ensure the area is safe for you and the casualty. If possible, move both to a safe location.
2. Expose the Injury:
   • Cut, tear, or remove clothing to expose the wound. This allows for clear visualization and proper tourniquet placement.
3. Positioning:
   • Place the Tourniquet:
     • Position the tourniquet high and tight on the limb.  Placing it high and tight is the best method to make sure the tourniquet is secure from coming loose and that the bleeding stops.
   • Avoiding Joints:
     • Do not to place the tourniquet directly over a joint because it will be less effective and more painful. 
4. Application:
   • Windlass or Buckle System:
     • If using a windlass tourniquet (like CAT), route the windlass strap through the buckle, then twist the windlass rod until bleeding stops. Secure the windlass rod in place.
   • For Non-Windlass:
     • Tighten the tourniquet using the provided mechanism until bleeding stops.
5. Check for Bleeding Control:
   • After tightening, check the wound to ensure no blood is flowing. If bleeding continues, you might need to reposition the tourniquet or tighten it further.
6. Secure and Note Time:
   • Secure the windlass or strap to prevent unwinding.
   • Note the exact time the tourniquet was applied. This is crucial information for medical personnel.
7. Mark the Tourniquet:
   • Use a pen or marker to write ‘T’ and the time on the casualty’s forehead or another visible place. This alerts medical teams that a tourniquet is in use and how long it has been applied.

Post-Application Care:

• Monitor the Casualty: Keep an eye on the patient for signs of shock or further complications.
• Do Not Remove: The tourniquet should not be loosened or removed until the casualty is under professional medical care. Releasing a tourniquet can lead to rapid blood loss.

Training and Preparation:

• Regular Training: Regularly practice applying tourniquets to ensure proficiency. Muscle memory is key in high-stress situations.
• Carry Tourniquets: In combat or high-risk environments, carry tourniquets where they are easily accessible.

Common Mistakes to Avoid:

• Applying too low: Tourniquets must be above the wound, not directly over it. High and tight on the limb is the best practice.
• Not tightening enough: Ensure bleeding has completely stopped. If in doubt, tighten more. It’s almost impossible to tighten a proper combat tourniquet too much. Tightening the tourniquet may cause the victim pain but the goal of stopping the bleed must come before the comfort of the victim. 
• Overlooking time notation: Noting the time of application is critical for medical treatment.