What are the indications and proper technique for applying a tourniquet in extremity trauma?

• A. Indicated for life-threatening limb bleeding not controllable by direct pressure; place 2-3 inches above wound, tighten until bleeding stops; note time of application; do not remove in field until definitive control
• B. Indicated for cosmetic bleeding
• C. Place over wound and loosen frequently
• D. Apply only after full imaging

Answer: (A)

The main idea is stopping life-threatening limb bleeding when direct pressure can’t control it. A tourniquet should be placed 2–3 inches (about 5–7 cm) above the wound, toward the torso, avoiding placement over a joint or a fracture site. Tighten it until the bleeding stops and distal perfusion is effectively controlled; once applied, the time of application should be documented because prolonged ischemia increases limb risk. Do not remove or loosen the tourniquet in the field until definitive surgical or medical control is achieved, as releasing it can lead to renewed hemorrhage. Wide, firm compression with a windlass or strap helps ensure a secure, lasting seal. This approach isn’t used for cosmetic bleeding, shouldn’t be placed over the wound with repeated loosening, and isn’t contingent on imaging before application.