How to Apply a Tourniquet

Confirm an improvised tourniquet is needed

Only proceed with an improvised tourniquet if direct pressure has not stopped the bleeding and no commercial tourniquet is available. This procedure is intended as a last resort for severe limb bleeding.

Prepare the tourniquet material

Fold your chosen material — such as a triangular bandage — to a minimum thickness of 5 cm. It should be tight but not excessively tight to avoid causing additional injury. Apply it directly onto the skin where possible, though it can be used over clothing if necessary.

Safety note: Never place the tourniquet over a wound site or a joint. Position it on the mid-shaft of the limb bone, away from joints.

Position the tourniquet on the limb

Identify the location of the wound. Place the tourniquet on the upper arm, or above the wound on the affected limb, keeping it away from any joint and on the mid-shaft of the bone. This positioning is what allows the tourniquet to effectively stop arterial blood flow.

Apply the tourniquet band

Wrap the folded dressing around the limb, above the wound site. Tie a half knot over the top of the limb and pull it tight to begin restricting blood flow.

Select a suitable windlass

Choose a strong, rigid object — such as a piece of timber, metal, or a knife handle — to use as a windlass for tightening the band. Avoid fragile items like pens, as they may break under pressure and fail to tighten the tourniquet effectively.

Insert the windlass and tighten

Place the windlass over the knot in the bandage and tie the bandage over it to secure it in place. Begin twisting the windlass to tighten the tourniquet, increasing pressure on the limb. Continue winding until the bleeding slows or stops completely.

Safety note: Tell the casualty the procedure will be uncomfortable but is necessary to save their life by stopping the bleeding. Make sure the tourniquet is tight enough to stop all blood flow, not just venous return — if blood continues to ooze or spurt, twist further to apply more pressure.

Secure the windlass

Once bleeding has stopped, use the loose ends (tails) of the bandage to secure the windlass in place. Tuck the tails under the windlass and tie them to prevent it from unwinding.

Leave the tourniquet in place

Do not remove the tourniquet once it has been applied and bleeding has stopped. Leave it in place until the casualty reaches emergency medical care, and do not cover it with clothing or other materials — it must remain visible so emergency responders can see it has been applied.

Inform emergency responders

When paramedics or emergency personnel arrive, clearly tell them that a tourniquet has been applied to the casualty. This step is crucial, as the presence of a tourniquet may otherwise be missed if not pointed out. Keep it visible and uncovered at all times.

Mark the casualty with a 'T' and the time of application

Using a pen, write a large, clear 'T' on the casualty's forehead to indicate that a tourniquet has been applied. Write the exact time of application next to the 'T'. This information is vital for hospital staff, as it can significantly affect treatment decisions based on how long the tourniquet has been in place.