Tourniquet Staging and Preparedness for Trauma

by Superesse Staff June 01, 2023

TOURNIQUET PURPOSE

A TQ is designed to encircle the limb with a wide strap that is then tightened with a windlass rod. As torque (by twisting) is applied to the rod, it tightens the strap making it compress the extremity (arm/leg) causing it to compress the blood vessels and subsequently decreases and stops blood flow past the application sight. In short, it can prevent you from bleeding out and dying while increasing the time you'll have to obtain aid to treat the injury.

TOURNIQUET CARRY AND STAGING

Keep a tourniquet (TQ) easily accessible and always stage one on-body when carrying a firearm. Stage it for quick application. This means; attached it (ankle, hip, fanny pack, etc) ony your person in the same place each time your wear it so it increases "muscle memory" allowing you to grab it and deploy with little complex thought (because when a TQ is needed there will already be much to process).

Assess the injury. If it is obvious that direct pressure will not slow or stop the bleeding a TQ is necessary. We dive deep into diagnosis and first-response trauma assessments in our Worst Case Scenario First-Aid Guide. The guides focuses on how to react and treat injuries/illnesses when EMS and Hospitals don't exist or are unavailable.

Apply the TQ to the injured leg and/or arm 2-3 inches above (the side closest to heart) the wound while avoiding joints. Do so by wrapping the strap around the extremity (can be expedited if the TQ is pre-staged with a large loop) ensuring that you run the strap through the outer polymer loop opening (friction buckle). Pull the strap as far (tight) as you can cinche around the extremity then attach it to the velcro. Tighten the windlass rod until the bleeding stops (or is manageable with additional TQs, pressure bandages, wound packing) then secure the rod in the windlass clip. Fold over the windlass strap and mark the time.

Train with your TQ by aiming for a decreased time (time it takes to collect and properly apply) and proper application. Also train with a simulated injured arm and apply using the one hand method.

Always keep a TQ at home, in your vehicle, and on your person (EDC) when applicable (such as when carrying firearm or in exposed public areas).

Pre-stage the TQ with the windlass strap open. Create a large loop and adhere end of TQ so it just barely attaches to itself on the end (red tab). This creates a slide on loop and skips the use of fine motor skills needed to run the tabbed end through the friction buckle.

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Let's dig in a little bit more.

Know the two main TQs - CAT tourniquet and SOFT-T

CAT tourniquet

Adjustment strap uses velcro to ensure the tourniquet doesn't loosen

Has a smooth plastic windlass for tightening

The end of the adjustment strap is red making it easier to locate

There are 2 hooks for hooking in the windlass with a velcro strap which prevents windlass from slipping out

Application on yourself is quicker than SOFT T - Wide

SOFT T - Wide tourniquet

Adjustment strap uses a friction buckle system which prevents it from loosening

Has a textured metal windlass for tightening

There is a metal latch on the adjustment strap which allows it to be applied to a trapped limb much easier

Has a triangular latch which locks on to a groove on the end of the windlass

Is preferred for lower limb bleeding

How to use a tourniquet

If possible apply pressure on the wound in order to aid in stopping the bleed

Thread the tourniquet as high as possible on the extremity

Pull the adjusting strap until tourniquet is secure, if using a CAT secure with velcro

Twist windlass until bleeding stops

Secure windlass into the latch system

Write down the time the tourniquet was applied

It is advised not to leave a tourniquet on for longer than 2 hours to prevent permanent nerve damage

Improvised tourniquet

You can make your own tourniquet using a piece of fabric or a T-shirt, you need to ensure the material is long enough to wrap several times tightly around the limb, and the material should be 2-4 inches wide in order to apply enough pressure.

How to apply improvised tourniquet

Wrap fabric/shirt around the injured limb several times making sure its high and tight

Tie a square knot with the ends

Insert a stick or something long and sturdy enough through the knot to create a windlass

Lifting up slightly while twisting the windlass will aid in preventing pinching of the skin

Remember a windlass needs to be secured in order to be effective, use another piece of fabric, shirt or bandage to secure it.