How to Use a Tourniquet

1
Position and Tie the Tourniquet Above the Wound

Tying a tourniquet above the wound
Tie the tourniquet above the wound (on the side closer to the heart). © Rod Brouhard

Tourniquets are tight bands used to control bleeding by completely stopping the blood flow to a wound. Tourniquets have a bad rap in the field of emergency first aid. Complications of tourniquet use have led to severe tissue damage. However, tourniquets can arrest bleeding quite well and are useful in cases of severe bleeding that cannot be stopped in any other way.

For a one-page version of this tutorial, see How to Apply a Tourniquet.

If you are not the victim, practice universal precautions and wear personal protective equipment if available.

Before using a tourniquet, try using less damaging steps to control bleeding. If the scene is unsafe, and there is no time to attempt other steps, tourniquets can be used to control active bleeding.

Getting Started

To make a tourniquet, use a non-stretchy material, such as terry cloth or a cravat (also known as a

triangular bandage

), and fold it lengthwise until it's between 1 and 2 inches wide.

Tie the tourniquet around the injured arm or leg, several inches above the injury (the part of the limb closer to the heart). If the injury is below the elbow or knee, you may need to tie the tourniquet above the joint (see photo). Use a common square knot (like tying your shoes without the bow).

2
Add a Windlass

Adding a windlass to a tourniquet
Use any object strong enough to twist the tourniquet as a windlass. © Rod Brouhard

Place a stick or other item strong enough to act as a windlass (a lever that will twist the tourniquet tighter) on the knot and tie the loose ends of the tourniquet around it in another square knot (see photo).

Anything can be used as a windlass, as long as it is strong enough to hold the tourniquet and can be secured in place. Consider using pens or pencils, sticks, spoons, or even a piece of pipe like that in the photo.

3
Twist the Windlass to Stop Bleeding

Finished tourniquet
Once the tourniquet is tight enough to stop bleeding, secure it in place. © Rod Brouhard

Twist the windlass to increase the pressure until the bleeding stops.

Secure the windlass by tying one or both ends to the victim's arm or leg.

If possible, mark the time the tourniquet was placed by putting a "T" on the victim's forehead with the time/day.

For more information on when to properly use tourniquets, read Understanding Tourniquets.

Source: Beebe, Richard, and Deborah Funk. Fundamentals of Emergency Care. 2001. Delmar.

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