Table of Contents
- What Is a Tourniquet?
- How to Use a Tourniquet
- The Stop the Bleed Movement
- Tourniquets Save Lives
- How to Use a Tourniquet FAQs
A father and son are out for a weekend hike when an accident changes everything. A slip on loose rocks sends the father tumbling, and when he lands, a sharp branch cuts deep into his leg. Blood pools fast. His son fumbles for his phone, but there’s no signal. Panic sets in.
Then he remembers the tourniquet in their first aid kit. But does he know how to use it?
Having a tourniquet is one thing; knowing how to apply it correctly is another. In a situation like this, hesitation or mistakes can cost precious time. That’s why learning how to use a tourniquet before an emergency happens is essential.
Read on to learn when to use a tourniquet, how to apply one effectively, and the mistakes to avoid.
What Is a Tourniquet?
A tourniquet is a device used for medical procedures — such as starting an IV or controlling blood flow during surgery — or to stop life-threatening bleeding — particularly from severe trauma like deep lacerations, amputations, or gunshot wounds.
Here, we’ll focus primarily on tourniquets that are most commonly applied in emergency situations where excessive blood loss poses a life-threatening risk, especially when direct pressure or other wound care methods are ineffective.
Tourniquets are widely used in military, emergency medical services, law enforcement, first aid, and surgical settings to prevent hemorrhagic shock and stabilize a victim until professional medical care is available.
During a life-threatening bleeding emergency, a tourniquet has one goal: to apply pressure to stop severe bleeding.
Tourniquets can be improvised using available materials, but commercial tourniquets are specifically designed for effective use.
Common materials used in tourniquets include:
- Velcro bands or cuffs for secure fastening
- Ratcheting or twisting tightening devices
- Large rubber band wraps
Trauma tourniquets are designed for severe bleeding and use a sturdy nylon strap with a windlass (a stick or rod) so the necessary pressure is more easily applied. Without a windlass, a tourniquet may not be tight enough to restrict blood flow effectively.
When Should a Tourniquet Be Used?
The primary purpose of a tourniquet is to stop severe bleeding from a wound in the arms or legs. If uncontrolled, arterial bleeding can cause a person to lose a significant amount of blood within minutes, leading to shock or death. Tourniquets are used in situations where direct pressure is ineffective.
Tourniquets are essential for:
- Surgical procedures. Surgeons apply medical tourniquets to temporarily restrict blood flow for a clearer surgical field.
- Trauma and emergency care. Life-threatening injuries to the extremities such as deep lacerations, amputations, or gunshot wounds. These types of injuries may occur in:
- Military and combat situations. Battlefield medics use tourniquets to stabilize wounded soldiers before evacuation.
- First aid and disaster response. Used by both civilians and professional responders to control bleeding before medical help arrives.
Whether in combat, emergency medicine, or surgery, their ability to quickly control hemorrhaging makes tourniquets an essential part of any trauma kit. However, their use requires proper training and understanding — applying a tourniquet incorrectly or unnecessarily can be harmful.
When Should a Tourniquet Not Be Used?
A tourniquet shouldn’t be used if the bleeding is minor or can be controlled with direct pressure, wound packing, or other standard first aid techniques. Applying a tourniquet unnecessarily can cause severe tissue damage.
Additionally, improvised tourniquets made from items like belts, shoelaces, or cords are often ineffective and can cause more harm than good. If a commercial tourniquet isn’t available, it’s crucial to apply direct pressure and seek medical help as quickly as possible.
An exception to this rule may apply if you have practiced making improvised tourniquets enough to be proficient with them. Rescuers often run into problems when they’re trying to use an improvised tourniquet but can’t apply it quickly enough, and the victim ends up losing more blood.
Types of Tourniquets
Tourniquets come in different designs depending on their purpose. Some are commercially manufactured for emergency or medical use, while others may be improvised in urgent situations. Understanding the differences can help ensure the right type is used effectively and safely.
What’s the difference between commercial and improvised tourniquets?
- Commercial tourniquets are professionally designed, are tested for effectiveness, and often feature a windlass mechanism or other tightening system.
- Improvised tourniquets are made from available materials like cloth or belts but are often less effective and more dangerous if applied incorrectly.
Common types of tourniquets include:
- Emergency and trauma tourniquets. These tourniquets are designed for first responders, military personnel, and civilians in life-threatening situations. They often have a windlass mechanism for sufficient pressure.
- Surgical tourniquets. These tourniquets are used in medical procedures to temporarily cut off blood supply, providing a clearer surgical field. They’re typically inflated with air to maintain controlled pressure and commonly used in orthopedic, vascular, and reconstructive surgeries.
- Venous tourniquets. These tourniquets are applied during blood draws, IV insertions, and minor medical procedures. These are usually rubber or fabric bands that temporarily slow blood flow without stopping it completely.
- Blood-flow restriction tourniquets. These tourniquets are used in rehabilitation and strength training to partially restrict blood flow, aiding in muscle growth and recovery without completely stopping circulation.
While all tourniquets are designed to control blood flow, their purpose and effectiveness depend on the situation. Commercial tourniquets provide a reliable and safe way to stop severe bleeding, while improvised tourniquets should only be used as a last resort.
Choosing the right tourniquet and knowing how to use it properly can make a critical difference in both emergency and medical settings.
How to Use a Tourniquet
The first line of defense in controlling bleeding is usually direct pressure. Always start by applying firm pressure to the wound using a clean cloth or your hands. If direct pressure doesn’t stop the bleeding, or if the bleeding is so severe that it can’t be controlled with pressure alone, then a tourniquet is the next step.
A tourniquet is designed to cut off blood flow to the affected limb by constricting the blood vessels, allowing the blood to clot and preventing the person from bleeding to death. It should be applied only in situations of severe bleeding and not for minor wounds or superficial injuries.
Identifying Life-Threatening Bleeding
Life-threatening bleeding can lead to death if not stopped immediately.
Arterial bleeding is a particular concern because it often results in blood spurting from the wound in time with the heart’s pulse. This type of bleeding can cause someone to lose a significant amount of blood within a very short period, and the person may go into shock or cardiac arrest without prompt intervention.
To learn more about arterial bleeding, check out our video.
Wounds that are deep and difficult to control with direct pressure, such as amputations, gunshot wounds, or trauma from accidents, often require a tourniquet. If the blood flow continues despite applying pressure, it’s time to use a tourniquet.
Injuries to the extremities, such as severe lacerations, deep cuts, or wounds from sharp objects, can also necessitate the use of a tourniquet.
A Step-by-Step Guide to Applying a Tourniquet
Knowing how to apply a tourniquet is an invaluable first aid skill that should be used with caution. Best practices ensure that you’re using a tourniquet properly and safely.
When following these best practices, you minimize the risk of complications and maximize the chance of saving a life:
- Tourniquets should be used only when direct pressure fails to control severe bleeding.
- The goal is to stop the flow of blood, not to crush the limb. A tourniquet should be tight enough to cut off arterial blood flow but not so tight that it causes unnecessary damage to nerves, blood vessels, or muscle tissue.
- Once a tourniquet is in place, it should only be removed by a medical professional. Removing a tourniquet too soon can cause a dangerous rebound effect, where the accumulated blood flow returns to the injured area and inflicts more damage.
- The proper use of a tourniquet should be practiced regularly. Tourniquet application is a skill that needs to be ingrained in your muscle memory, as it may be needed in a high-stress, emergency situation.
Once you’ve identified that life-threatening bleeding is present, the next step is to apply a tourniquet. The key to using a tourniquet correctly is to act quickly and follow the proper procedure to stop the bleeding.
Here’s a step-by-step guide to applying a tourniquet:
- Position the Tourniquet Correctly
Begin by locating the wound on the limb. Place the tourniquet at least 2-3 inches above the wound, closer to the torso but still far from any joints, such as the elbow or knee. The goal is to apply the tourniquet where it will exert the maximum amount of pressure to stop blood flow to the injured area.
- Tighten the Tourniquet
Once in position, pull or tie the tourniquet around the limb as tightly as possible. Most tourniquets, especially those with a windlass mechanism, allow you to twist and tighten it even more once it’s applied. Use the windlass or twisting rod to increase the pressure around the limb at least until the bleeding stops.
- Secure the Tourniquet
After achieving the desired tightness, secure the tourniquet in place by fastening the windlass or securing the tourniquet tie. This will prevent the tourniquet from loosening during transport.
- Mark the Time
Finally, you must mark the time of application on the tourniquet. This information will be essential for healthcare providers when they’re able to take over care. The time limit for tourniquet use is generally 1-2 hours; after that, significant tissue damage occurs.
With this guide, you can apply a tourniquet quickly and effectively to control excessive bleeding emergencies.
How to Apply a Tourniquet on Yourself
In a traumatic situation, you may need to apply a tourniquet to yourself. While this is more challenging, knowing how to do it properly can be the difference between life and death.
How to apply a tourniquet to yourself when help isn’t available:
- Use available materials. If you’re alone, you may need to use a scarf or any available fabric as a makeshift tourniquet.
- Position the tourniquet above the wound. Apply the tourniquet as high on the limb as possible for maximum pressure.
- Tighten the tourniquet. If you have a windlass-style tourniquet, twist it tightly. If you don’t, use a stick or another object to create more pressure around the fabric.
- Secure the tourniquet. Once tight, secure the tourniquet in place. Use any available resources to hold it in position until medical help arrives.
Though challenging, applying a tourniquet to yourself is possible with quick thinking and resourcefulness. Keep calm, use what you have available, and act fast to control the bleeding. Many commercially manufactured tourniquets can be easily applied with one hand, so make sure to consider this when purchasing a tourniquet.
Risks of Tourniquet Use
While tourniquets are highly effective in stopping severe bleeding, they come with certain risks if used improperly. Understanding these risks will help you make informed decisions about when to use a tourniquet.
When applied improperly or for prolonged periods, a tourniquet can cause permanent damage to the skin, muscles, and nerves in the affected limb.
If left on for more than 2 hours, a tourniquet may lead to tissue death and potential amputation. Compartment syndrome, where swelling inside the muscle compartments occurs, is also a risk if advanced medical treatment isn’t received soon enough. This cuts off blood flow and may cause severe pain, permanent muscle damage, or even organ failure.
If a tourniquet is too tight, especially with improvised tourniquets where the material used is too thin, it could cut into the good tissues and cause additional damage and possibly even more bleeding. On the flip side, a tourniquet that’s too loose will fail to stop the bleeding.
While tourniquets can save lives, they must be used with caution. Improper use or prolonged application can cause severe damage.
Common Tourniquet Mistakes & How to Avoid Them
Tourniquet use requires precision, and common mistakes can lead to ineffective application or unnecessary harm.
By learning the mistakes that people often make, like those listed below, you can avoid them and use a tourniquet to its full potential in an emergency.
- Placing a tourniquet on a joint: A tourniquet won’t be able to effectively stop bleeding if it’s positioned over a joint. Always place a tourniquet above the joint and closer to the torso.
- Applying a tourniquet too loosely: If a tourniquet isn’t tight enough, it will fail to stop bleeding. Make sure it’s tight enough to prevent blood flow but avoid over-tightening.
- Removing a tourniquet: Removing needed tourniquets should only be done at a hospital by advanced medical professionals. Removing a tourniquet too early may cause a dangerous surge of blood flow back to the affected area.
A tourniquet won’t work over a joint because it can’t tighten enough to stop blood flow.
Avoiding common mistakes makes using a tourniquet as effective as possible. With the proper application, in the right place, and with the correct amount of pressure, you can stop life-threatening bleeding.
Signs a Tourniquet Is Working
The signs below are indicators that a tourniquet is working correctly:
- No bleeding: A properly applied tourniquet should stop all bleeding from the wound. If bleeding continues, the tourniquet needs to be tighter or a second tourniquet can be applied closer to the torso than the first.
- No distal pulse: If you can still feel a pulse below a tourniquet, it’s not tight enough. A properly applied tourniquet should cut off arterial blood flow, meaning there should be no detectable pulse in the limb below the tourniquet.
- Firm but not excessive: A tourniquet should be tight enough to stop bleeding but not excessively tight. Some discomfort is expected, but it shouldn’t cause crushing damage to the tissues. If a tourniquet is too tight, it may cause more issues for the extremity.
Monitoring the effectiveness of a tourniquet is essential to check that the bleeding stops. If you notice signs that it’s not working, tighten it or apply a second tourniquet.
What to Do If Bleeding Doesn’t Stop
In some cases, a single tourniquet may not stop bleeding. If this happens, it’s important to know how to proceed in order to gain control of the situation and prevent additional blood loss.
If the bleeding doesn’t stop after applying a tourniquet, consider the following options:
- If blood is still flowing, tighten the tourniquet more using the windlass or ratcheting mechanism.
- If one tourniquet is insufficient, apply another one above the first one. This will add another layer to help reduce the blood flow.
- If you can’t tighten the tourniquet enough and you only have one tourniquet, try using direct pressure or a pressure bandage with the applied tourniquet.
- Call for help immediately. The less time bleeding, the better, so getting advanced medical care for the injured person as quickly as possible is critical.
If the bleeding doesn’t stop, don’t hesitate to take further action. The goal is to stop the bleeding and get the person to medical care as soon as possible for treatment.
The Stop the Bleed Movement
The Stop the Bleed Movement is a groundbreaking initiative designed to equip everyday people with the knowledge and confidence to act in life-threatening bleeding emergencies.
Administered by the American College of Surgeons Committee on Trauma (ACS COT) in collaboration with the U.S. Department of Defense, the Stop The Bleed program provides hands-on training in techniques like tourniquet application and wound packing.
Just like CPR empowers bystanders to assist someone in cardiac arrest, Stop the Bleed empowers people to take action before professional help arrives.
Severe blood loss, or exsanguination, can occur within seconds, and a 40% loss can be fatal.
Since its launch in 2015, the program has trained hundreds of instructors who now educate individuals from all walks of life, preparing more people to step in during an emergency. The movement has been so impactful that many schools, workplaces, and public spaces are now required to have bleeding control kits alongside first aid supplies.
(Image courtesy of the American College of Surgeons (ACS) Stop the Bleed program.)
Stop the Bleed uses tourniquets like this to teach and train their students. They’re also available online in their kits. These kits provide everything needed to control severe bleeding, including tourniquets, hemostatic dressings, and bandages.
At ProTrainings, we share the same mission as Stop the Bleed: to educate, empower, and instill the confidence needed to save a life. While our focus includes CPR and first aid training, Stop the Bleed provides essential bleeding control techniques, making it an important complement to our lifesaving education programs.
Stop the Bleed is a fantastic movement that has helped build awareness and save lives. In fact, we believe in the mission of Stop the Bleed so much that we’re using it as the foundation for a new course called Under Pressure.
Under Pressure includes a more comprehensive discussion of bleeding control in other areas of the body and improvised tourniquets. It incorporates extra hands-on skills and more realistic training videos. Be sure to follow us on LinkedIn for more updates on Under Pressure.
Tourniquets Save Lives
Knowing when and how to use a tourniquet can be a lifesaving skill in an extreme emergency. Severe bleeding can become fatal in just minutes, and the ability to take immediate action saves lives.
But bleeding control is just one piece of the puzzle. Emergencies are unpredictable, and having a well-rounded knowledge of first aid prepares you to respond to any situation effectively.
By learning what to do, and what not to do, ahead of time, you can act confidently and provide the best possible care when it matters most. First aid training equips you with the skills to assess injuries, control bleeding, perform CPR, and handle other emergency situations.
Whether you’re at home, work, or in public, being trained means you’re ready to step in and help when a life is on the line.
Did you know you can train for free on our website? Take the next step in emergency preparedness and gain hands-on experience with essential techniques, including tourniquet application, CPR, and first aid.
How to Use a Tourniquet FAQs
Many people — even those who know how to use a tourniquet — feel nervous or uncertain about using one because they’re afraid that they may cause harm to the injured person. However, the more you educate yourself about how to use a tourniquet safely and effectively, the better equipped you’ll be to save a life should the need arise.
When Should You Not Use a Tourniquet?
In the past, people learning how to use a tourniquet have been told to use one on a snake bite to prevent the venom from spreading. This is bad advice. A tourniquet keeps the venom concentrated, which can cause serious long-term damage to the limb.
Additionally, don’t use a tourniquet if:
- The wound is on the person’s head, neck, or torso.
- The bleeding isn’t life-threatening.
- You’re able to stop the bleeding by applying direct pressure to the wound.
Watch our video about venous bleeding to learn how to handle non-life-threatening bleeding injuries.
Who Is Qualified to Use a Tourniquet?
While you should always call for help in an emergency, there may not be time to wait for medical professionals to arrive before applying a tourniquet. The good news is that anyone who knows how to use a tourniquet and has the necessary materials can apply one.
If you see a person who might require a tourniquet, don’t wait — administer first aid to the best of your abilities while someone calls emergency services. You could very well save the person’s life!
How Tight Should a Tourniquet Be?
A tourniquet should be tightened until the bleeding completely stops. If blood continues to flow, the tourniquet isn’t tight enough and should be adjusted. It’s important to remember that a properly applied tourniquet will be uncomfortable, but that discomfort is necessary to prevent blood loss.
How Does a Tourniquet Work?
A tourniquet works by compressing blood vessels in an injured limb to stop hemorrhaging and prevent excessive blood loss. When tightened properly, it applies direct pressure to the arteries, which are responsible for carrying oxygen-rich blood from the heart to the rest of the body.
While veins are easier to compress, the goal of a tourniquet is to collapse the arteries beneath it, cutting off blood flow to the injury site.
How Long Can a Tourniquet Stay On?
Tourniquets are intended as an emergency measure, not a long-term solution. While there’s no single “safe” time limit, medical professionals generally recommend keeping a tourniquet on for no longer than two hours whenever possible.
Prolonged use increases the risk of nerve damage, muscle injury, and potential limb complications. However, in a life-threatening emergency, stopping the bleeding takes priority over these concerns.
Once a tourniquet is applied, it shouldn’t be removed or loosened except by a trained medical professional. Loosening a tourniquet prematurely can restart bleeding and worsen the situation.
When Should You Remove a Tourniquet?
You may have heard that you should loosen or remove a tourniquet after a certain amount of time to prevent tissue damage. However, only a medical professional should remove a tourniquet.
Don’t try to remove or loosen a tourniquet to make the person more comfortable, even if they complain that it’s too tight. It needs to be uncomfortably tight — and stay that way — to be effective.
Does Using a Tourniquet Always Mean Limb Loss?
No, applying a tourniquet doesn’t automatically mean a person will lose their limb. Prolonged use can cause complications, but thanks to modern emergency medical practices, the risk of amputation is significantly reduced. In most cases, tourniquets are used for short periods to prevent fatal blood loss, and the limb remains intact.
Can You Use a Belt as a Tourniquet?
While a belt may seem like a logical choice in an emergency, it’s not an effective tourniquet in most cases. A proper tourniquet needs to be tightened with a windlass (a twisting mechanism) to apply the necessary pressure to stop arterial bleeding. Most belts are too stiff to be wound tightly enough, making them unreliable for bleeding control.
If a commercial tourniquet is unavailable, it’s better to use a strong, wide material that can be twisted with a sturdy object (such as a stick or pen) to create a functional windlass. However, the best course of action is always to carry a proper tourniquet as part of a first aid kit.
How Do You Train for Proper Tourniquet Use?
The best way to prepare for an emergency is through hands-on training from a trusted provider. ProTrainings offers comprehensive first aid and bleeding control courses that teach you how to recognize severe bleeding, apply a tourniquet properly, and take action in an emergency.
In addition to live training, online courses and instructional videos can provide valuable knowledge. However, practicing with an actual tourniquet is the most effective way to know how to apply one correctly when needed.
Do Tourniquets Hurt?
Yes, a properly applied tourniquet will be painful, but that’s a sign that it’s working.
Tourniquets stop bleeding by compressing blood vessels, nerves, and muscles, which naturally causes discomfort. The sensation is often described as a severe cramping, burning, or throbbing pain, similar to an extremely tight muscle cramp. Additionally, since tourniquets cut off blood flow, the affected limb may feel numb, tingly, or achy.
Despite the pain, never loosen or remove a tourniquet before medical professionals arrive. If a tourniquet doesn’t cause discomfort, it may not be tight enough to stop the bleeding. While tourniquets can be uncomfortable, they’re far less painful than the consequences of uncontrolled bleeding.