Tourniquet: when to use one, and how to apply it correctly
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- North American Rescue C-A-T Combat Application Tourniquet. Best for: Home, car and trauma kits. See options on Amazon
- Bleeding control kit with tourniquet. Best for: A ready-made car or workplace kit. See options on Amazon
When a tourniquet is needed
MedlinePlus says to put direct pressure on an external wound first, with a sterile bandage, clean cloth or even clothing. If continuous pressure has not stopped the bleeding and the bleeding is extremely severe and life threatening, a tourniquet can be used until medical help arrives. The Los Angeles Fire Department (LAFD) says that if the injury is to a leg or an arm, you should use a tourniquet.
The LAFD warns that severe bleeding can lead to death in as little as 5 minutes. Call 911, or have someone call, and put the phone on speaker while you give first aid.
How to apply a tourniquet
| Step | What to do | Source |
|---|---|---|
| 1. Find the bleeding | Remove clothing covering the area to locate the source | LAFD |
| 2. Place it | 2 to 3 inches above the wound; not on a joint, go above it if needed | LAFD, MedlinePlus |
| 3. Tighten the strap | Pull the free end tight | LAFD |
| 4. Twist the windlass | Wind until the bleeding stops, then secure it in place | LAFD |
| 5. Note the time | Write it down or tell first responders | LAFD, MedlinePlus |
MedlinePlus adds that, if possible, the tourniquet should not go directly on skin, where it can twist or pinch; apply it over padding or over a pant leg or sleeve. It also says keeping a tourniquet on too long can injure nerves and tissues, which is why responders need the time.
Commercial tourniquets
Commercial tourniquets use a strap and a windlass, a rod you twist to tighten. North American Rescue describes its Combat Application Tourniquet (C-A-T) as a one-handed tourniquet with a free-moving internal band that gives circumferential pressure; the windlass locks in place once bleeding stops, and a hook-and-loop strap secures it. The maker says it is the official tourniquet of the U.S. Army and is recommended by the Committee on Tactical Combat Casualty Care. It also sells a blue-colored version to mark it as a training device, so check the color and label you buy.
North American Rescue's site links to information on blocking imports of counterfeit tourniquets and counterfeit tourniquets, so check that the product is genuine.
If you have to improvise
MedlinePlus describes making a tourniquet only if no commercial one is available: use bandages 2 to 4 inches wide wrapped around the limb several times, tie a half or square knot leaving long ends, place a stick or stiff rod between two knots, twist until the bandage is tight enough to stop the bleeding, and secure it. Write down the time. MedlinePlus also says that if you have a first aid kit that comes with a tourniquet, apply that to the limb instead.
While waiting for help
- Tell responders the time. Both sources say to note when the tourniquet went on and share it with first responders.
- Do not peek. MedlinePlus says the less a wound is disturbed, the more likely the bleeding stays controlled.
- Do not remove embedded objects. MedlinePlus says pulling out a knife, stick or other object can cause more bleeding; pad around it instead.
- Add, do not remove. If a dressing soaks through, MedlinePlus says place another cloth on top rather than removing the first.
- Prevent shock. Lay the person flat, raise the feet about 12 inches if there is no head, neck, back or leg injury, and cover them with a coat or blanket; see our emergency blanket guide.
Training and your kit
North American Rescue links to training courses and educational videos for its C-A-T, and sells a blue training version so people can practice without confusing it with a real device. A first aid or bleeding control class lets you practice the steps before you need them.
Keep a tourniquet with the rest of your supplies, alongside gauze for pressure; see our gauze pads guide and first aid kit guide. Follow the maker's instructions for checking and replacing it.
What to look for when you buy
North American Rescue C-A-T Combat Application Tourniquet
Best for: Home, car and trauma kits
The maker describes a one-handed windlass tourniquet recommended by the Committee on Tactical Combat Casualty Care.
Watch out: A blue version is for training only; buy genuine product from authorized sellers.
See options on AmazonBleeding control kit with tourniquet
Best for: A ready-made car or workplace kit
Some kits on Amazon pair a CAT tourniquet with gauze and gloves for the pressure step.
Watch out: Check which tourniquet model is included and that it is genuine.
See options on AmazonQuestions people ask
- Where do you place a tourniquet?
- 2 to 3 inches above the wound, not on a joint; go above the joint if needed.
- How tight should a tourniquet be?
- Twist the windlass until the bleeding stops, then lock it, per LAFD.
- Why write down the time?
- MedlinePlus says keeping a tourniquet on too long can injure nerves and tissues; responders need the time.
- Can I make a tourniquet?
- MedlinePlus describes using 2 to 4 inch wide bandages and a stick as a windlass if no commercial one is available.
- Should I loosen a tourniquet to check the wound?
- No. Leave it on and tell responders when it was applied.
Sources
- Bleeding (medlineplus.gov), MedlinePlus, U.S. National Library of Medicine
- Stop the Bleed: Tourniquet (lafd.org), Los Angeles Fire Department
- Combat Application Tourniquet (C-A-T) (narescue.com), North American Rescue