How to Use a Tourniquet to Control Major Bleeding

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Learning how to make a tourniquet or how to use different types of tourniquet is a must for everyone.

We’ve all seen the movies where a wounded hero rips a piece of his t-shirt and ties it around a limb to use as a tourniquet.

In real life, using a tourniquet this way would almost certainly result in failure and death.  You need a wide tourniquet applied very tightly to stop limb bleeding.

Because of how misunderstood the tourniquet is, many health agencies have started campaigns about proper tourniquet use. This guide is our contribution to the mission.

Read on to learn about how to save a life with a tourniquet.

What Is A Tourniquet

Tourniquets are tight bands used to completely stop the blood flow to a wound.

To control bleeding after an injury to a limb, tourniquets should ideally only be used by first responders trained in emergency first aid. Knowing when (and when not) to use a tourniquet to control bleeding can be difficult to ascertain.

Why Should You Have a Tourniquet

No one wants to be at the center of a medical emergency.

But accidents, natural disasters, and shootings happen – and they happen without warning. Emergency situations like these turn average citizens into first responders in an instant. Being prepared could be all that you need to save a life.

When a traumatic injury on an arm or leg leads to rapid blood loss, a properly applied tourniquet is the most important piece of equipment you can have.

A tourniquet will safely limit the amount of blood the victim will lose before receiving hospital treatment.

Recommended Types Of Tourniquet

Why You Need Tourniquet Knowledge

Tourniquets have been used for hundreds of years, especially by soldiers.  For example, during the US Civil War, soldiers were told to carry a bandana and stick so they could make a tourniquet.

Even with today’s medical breakthroughs, tourniquets are still an integral part of first aid in the battlefield.  Proper tourniquet use is taught as part of TCCC (Tactical Combat Casualty Care) and is attributed to saving many soldiers’ lives.

Most of the information about how to apply a tourniquet is geared towards soldiers.  If you aren’t a soldier, you might think that you don’t need to know about tourniquets.

But there are many everyday situations where tourniquets could save lives:

  • Mass casualty events
  • Vehicle collisions and accidents
  • Falls
  • Hiking accidents
  • Knife wounds
  • Shootings

For example, tourniquets saved many lives during the Las Vegas shooting. The trauma team caring for the Tree of Life synagogue victims estimates that tourniquets applied at the scene saved at least three lives.

Tourniquet use is so important that public health organizations are creating awareness campaigns for the general public.

In the US, the Stop the Bleed awareness campaign educates on bleeding control and FEMA has worked to get tourniquets in more public places.  

In the UK, the public is also being brought up to date with military protocols.

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How To Use A Tourniquet

Tourniquets are ONLY applied on limbs! Never on a neck!

Major bleeding control practices in areas not accessible by tourniquets (like the stomach and back) will be covered further at another time.  

With that out of the way, here are the steps of applying a tourniquet:

Step #1

Wrap the limb with a rope/belt/bra at least two inches closer to the body than the wound. Do not apply a tourniquet over a joint–blood passageways are protected in joints, and you’ll never put pressure on the arteries.

Step #2

Place it closer to the body than the joint.  Then tie the tourniquet in place once using an overhand knot.

Step #3

Place your desired torsion device on top of the overhand knot. Tie another overhand knot, then another (or tie a square knot if you’re knot savvy) to secure the torsion device onto the tourniquet.

Step #4

Twist the torsion device in one direction until bleeding stops.

Step #5

Secure the tourniquet in place. This can often be accomplished by using the loose ends from your last knot to tie one end of the torsion device to the tightened tourniquet, or to the limb. 

And write the exact time the tourniquet has been applied.

Related post: How To Use A Butterfly Bandage

Top 6 Most Common Tourniquet Mistakes

Even if you know how to properly use a tourniquet, it's possible to make errors.

In an emergency, you may not have enough help or resources, and you will likely face many distractions.

The following are potential errors to be aware of when applying a tourniquet:

Mistake #1

Waiting too long. You must address severe bleeding immediately for a tourniquet to be successful. When an injured person loses too much blood, they may go into shock.

Mistake #2

Loose application. Loose tourniquets are not effective as they fail to sufficiently constrict arterial blood flow.

Mistake #3

Not applying a second tourniquet. One tourniquet is usually enough to control severe bleeding, however, a person with large arms may require a second tourniquet. 

Mistake #4

Loosening. Constricting and loosening the tourniquet rather than continually constricting allows blood to reenter to the injury. If blood flows back to the injury, it can damage the blood vessels. 

Mistake #5

Leaving on too long. A tourniquet should not be left for longer than two hours. When applied for a longer time, tourniquets can cause permanent damage to muscles, nerves, and blood vessels.

Mistake #6

Using the wrong materials. Inappropriate materials, such as a cord, can cut into the skin. Not only does this render the tourniquet ineffective it can also cause more pain or result in further injury.

The best way to prevent mistakes is to be informed about how to use a tourniquet and practice the proper technique for applying one.

Types Of Tourniquets

In today’s military, all soldiers are issued tourniquets to accompany their armor and weapons, and every soldier is trained and proficient at applying his tourniquet–even one-handed on his own arm.

The best tourniquet is probably the one used by the army, the Combat Action Tourniquet (CAT tourniquet).

But this tourniquet is made for single-handed application; they run around $30 and aren’t practical for a civilian to carry around in his pocket every day.

Another great type of tourniquet is the Recon Medical.

If you don't want to buy a tourniquet, luckily for you,  tourniquets are everywhere.

Are you wearing a belt? 

Tourniquet! 

Have laces on your shoes? 

Tourniquet!

Long sleeve shirt, bicycle inner tube, backpack strap, or a female brassiere? 

All tourniquets! 

If you’re in the woods I recommend using, well, a stick.

If there are absolutely no sticks or stick-like objects around you, then close your knife’s blade, or put the sheet on it, and give it up for a good cause.

It’s now your torsion device.

How To Make A Tourniquet

  1. Choose a wide, strong piece of material. A triangle bandage, scarf, or bandana will work. Avoid thin items such as phone cables if you can. Belts also will not work.
  2. Cross the material above the wound.
  3. Put a tightening rod in place. A stick or carabiner will work. Avoid items like pencils which can easily break.
  4. Make a knot around the rod with the tourniquet material.
  5. Twist the rod. You will need to twist tightly to stop blood flow.
  6. Secure the rod in place. This can be done by tying another piece of material around it. Hair bands will also work.

As you can see, it's easy to learn how to make a tourniquet. A DIY tourniquet is better than nothing.  But impromptu tourniquets are very likely to fail – especially if you didn’t use a windlass rod for tightening it.

Last Words

If 911 has not been called yet, do so now.

If rescue workers cannot get to you where you are, or there is no phone service, never leave the victim alone to look for help–grab them and go. Be prepared to do the fireman’s carry.

Congratulations! You now know how to make a tourniquet and how to use it so you can save a life! Go out unto the world knowing you can help make it a safer place.

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