Tourniquet Application: What You Need to Know Before You Need It

A tourniquet applied in the first few minutes after a traumatic injury can be the difference between life and death. Here is how to use one correctly.

Why Tourniquets Save Lives

Uncontrolled hemorrhage is the leading cause of preventable death from traumatic injury. In mass casualty events, accidents, and violent encounters, the difference between survival and death is often measured in minutes. A properly applied tourniquet can stop life-threatening bleeding from an extremity in seconds.

The CAT Tourniquet

The Combat Application Tourniquet (CAT) is the most widely used tourniquet in both military and civilian settings. It is the standard issue tourniquet for U.S. military personnel and is widely recommended for civilian carry.

Step-by-Step Application

Step 1: Identify the bleeding.

Confirm that the bleeding is from an extremity and that it is severe enough to warrant a tourniquet. Arterial bleeding is bright red and pulsing. Venous bleeding is darker and flows steadily.

Step 2: Position the tourniquet.

Place the tourniquet 2 to 3 inches above the wound, between the wound and the heart. Do not place it over a joint.

Step 3: Secure the band.

Thread the free end of the band through the buckle and pull it tight. The band should be snug against the skin.

Step 4: Tighten the windlass.

Twist the windlass rod until the bleeding stops. Keep twisting until the bleeding stops completely, not just slows down.

Step 5: Lock and secure.

Lock the windlass in the clip and secure it with the strap.

Step 6: Note the time.

Write the time of application on the tourniquet or on the patient's skin. Emergency responders need this information.

Common Mistakes

Not tightening enough. The most common mistake is not tightening the tourniquet until the bleeding actually stops. It should be tight enough to cause significant discomfort.

Placing it over a joint. A tourniquet placed over a knee or elbow cannot be tightened effectively.

Removing it in the field. Once a tourniquet is applied, do not remove it until the patient is in a hospital setting.

Using improvised tourniquets. Belts, shoelaces, and rope do not work reliably. Carry a real tourniquet.

Carry One

A CAT tourniquet costs about $30. It fits in a cargo pocket, a glove box, or a range bag. If you carry a firearm for self-defense, you should also carry a tourniquet. The two tools address the two most likely outcomes of a violent encounter.