When do I apply a tourniquet to a casualty? You're going to place a tourniquet on an uncontrolled extremity hemorrhage. If you can't control that bleeding with things like a pressure dressing or direct pressure, then you're going to place a tourniquet, which is going to occlude all blood flow down that extremity and stop the bleeding. Obviously, we don't want to place a tourniquet if we don't have to, but there are several times when you need to apply a tourniquet: blood that is spurting out of a wound, blood that won't stop coming out of the wound despite direct pressure, blood that is pooling on the ground, clothing that is soaked with blood if you've applied bandages, and those bandages become soaked with blood.

Loss of all or part of an arm or the leg, bleeding in a victim that is now unconscious or confused, apply that tourniquet two to three inches above the source of bleeding, and you want to apply that to direct skin if possible.

So if there's still an ongoing threat, then you might consider placing a tourniquet without doing some of the other measures. It's either not safe or you're not able to locate the site of that bleeding. In that situation, what you want to do is apply that high and tight. So you're going to do high up in the arm or high on the leg until you can remove that patient from that situation. At that point, you want someone properly trained to evaluate that tourniquet to see if it needs to be converted to a pressure dressing or relocated to two to three inches above that wound.

So remember, tourniquets are only for extremities, right? We're not going to place it around the neck. We're not going to place it around the torso. We're only going to place it from your armpit down on each side or your upper thigh all the way down. We're not going to place it over joints, so you don't want to place it over the elbow. You don't want to place it over the knee.