Apply Tourniquet Steps:
1. Improvising a Tourniquet. In the absence of a specially designed tourniquet, a tourniquet may be made from a strong, pliable material, such as gauze or muslin bandages, clothing, or cravats. An improvised tourniquet is used with a rigid stick-like object. To minimize skin damage, ensure that the improvised tourniquet is at least 2 inches wide. WARNING: The tourniquet must be easily identified or easily seen. WARNING: DO NOT use wire or shoestring for a tourniquet band.
2. Placing the Improvised Tourniquet.
a. Place the tourniquet around the limb, between the wound and the body trunk (or between the wound and the heart). Never place it directly over a wound, a fracture, or joint. Tourniquets, for maximum effectiveness, should be placed on the upper arm or above the knee on the thigh (Figure 2-32).
b. The tourniquet should be well-padded. If possible, place the tourniquet over the smoothed sleeve or trouser leg to prevent the skin from being pinched or twisted. If the tourniquet is long enough, wrap it around the limb several times, keeping the material as flat as possible. Damaging the skin may deprive the surgeon of skin required to cover an amputation. Protection of the skin also reduces pain.
3. Applying the Tourniquet.
a. Tie a half-knot. (A half-knot is the same as the first part of tying a shoe lace.)
b. Place a stick (or similar rigid object) on top of the half knot (Figure 2-33).
c. Tie a full knot over the stick (Figure 2-34).
d. Twist the stick (Figure 2-35) until the tourniquet is tight around the limb and/or the bright red bleeding has stopped. In the case of amputation, dark oozing blood may continue for a short time. This is the blood trapped in the area between the wound and tourniquet.
e. Fasten the tourniquet to the limb by looping the free ends of the tourniquet over the ends of the stick. Then bring the ends around the limb to prevent the stick from loosening. Tie them together on the side of the limb (Figure 2-36). NOTE: Other methods of securing the stick may be used as long as the stick does not unwind and no further injury results. NOTE: If possible, save and transport any severed (amputated) limbs or body parts with (but out of sight of) the casualty.
f. DO NOT cover the tourniquet—you should leave it in full view. If the limb is missing (total amputation), apply a dressing to the stump. All wounds should have a dressing to protect the wound from contamination.
g. Mark the casualty’s forehead with a “T” and the time to indicate a tourniquet has been applied. If necessary, use the casualty’s blood to make this mark.
h. Check and treat for shock.
i. Seek medical aid.
CAUTION: Only appropriately skilled medical personnel may adjust or otherwise remove/release the tourniquet in the appropriate setting.