First Aid for Splints & Bleeding Wounds : How to Use a Tourniquet

My name is Alv Rios and I am a paramedic with
Lansing Mercy Ambulance on behalf of Expert Village. In this clip we are going to over
tourniquet use to help control blood loss. Tourniquets should be used only as a last
resort for blood loss control. A tourniquet should be applied once you’ve came to a conclusion
that you are not able to control the blood loss with direct pressure, elevation and pressure
point combined. Once you realize that it’s not controlling the blood loss what you are
saying to yourself is I’m now going to put a tourniquet on. This tourniquet is going
to cut off complete blood flow to the extremity. Here again by lacking the extremity from getting
the blood flow it needs it’s going to actually start to die and tissue narcosis will begin.
What that means is by putting on the tourniquet you are saving the person’s life from the
blood loss but you are sacrificing that limb and it shouldn’t have to be amputated if put
on correctly. This is an example of a commercial product you can buy. Anything can be used
similar to this such as a piece of clothing or belt. Once you have opened this from the
package you will have the triangular bandage. What this is very similar to is a bandanna.
I’m not going to open it all of the way up because for the sake of this I want it to
look just like this. What you want to have is approximately two inches wide of material.
You always want to go approximately two inches above the injury site also. For this sake
of this example we are going to say that I am loosing blood from just above my knee here
and it’s an arterial bleed. Which means it is bright red squirting blood. I’ve been unable
to control it with direct pressure and elevation of my leg and by pushing on my femoral artery
right here I was still not able to control the blood loss. I then move into my tourniquet.
It’s important to remember the two by two rule. This is my injury site. You want to
go two inches above the injury site and you want to have the material to use your tourniquet,
approximately two inches wide. So what you want to do is put it right over above the
injury site, you then want to make sure this is extremely tight and come up to the top
and make a small knot and try to get that as tight as you can. You are not able to actually
pull this tight enough to completely elude the blood flow. It is very important that
this is extremely tight because if you only put it on partially what you are going to
do is squeeze the blood vessels which is still going to have blood flow and going to cause
the bleeding but it is actually going to increase blood flow because the body is going to think
that it is having a lack of the blood. So it is going to try to increase the blood flow
to that injury site. So it’s very important that if you decide to put on a tourniquet
you are going to completely elude all blood flow to the extremity distal that spot. Next
you want to use something; I am going to use a pencil for this. You can use a pen. Anything
long a little bit hard, you can eve use a stick. Just set it right over the injury site.
What you are then going to do is just wrap the ends around like this and give it another
tie here. This is just tying into place. What you are now joint to do is start to actually
spin it around. As you spin it, it is going to tighten here. I am going to stop it here
for the sake of I don’t want to cut the blood flow off completely to my leg. But that will
be sufficient enough. Once you have it as tight as you think you can go or to the breaking
point of whatever object you used what you then want to do is secure it into place. If
I let this go it will start to spin it’s self around again and release. So what I want to
do is lock it in place. I do this by taking my two ends that I have left and wrapping
it around and then tying its self back together again. Keep in mind it’s going to release
just a little bit but it should stay in place.


  1. as said, a tourniquet is only to be used for severe bleeding as a last resort, if there is no other option, like if there is, according to the us army's manual of common tasks, an amputation, quick clots awesome and all, but it cant stop an amputation.

  2. …. A wound really should not require a tourniquet unless there are arterial bleeding. An injury to the arm or leg does not necessarily involve an artery. Blood should be being propelled from the injury, if a tourniquet is necessary. Arterial bleeding, and only if it cannot be stopped with elevation, direct pressure, and indirect pressure.

  3. It is not illegal to use a tourniquet, they're allowed.

    Because a tourniquet is so damaging, and won't even be effective if used improperly, it is seldom recommended in common first aid instruction. Inexperienced care givers could panic, and apply a tourniquet when it isn't needed. They could use it incorrectly, resulting in the person still bleeding out, when the other, simpler methods may have saved them if used properly.

    It's easy to use it incorrectly or unnecessarily.

  4. all the information on changing. It is NO LONGER a last resort…google army, and some of the NEW information!! help get the word out…

  5. You can reperfuse the arm after use of a tourniquet….google tourniquet research out of iraq, and read some of the advancing coming out of there. Most of our protocol and education comes from war…read…and I am really glad you still have your arm!!

  6. I have only a plastic windlass type tournaquet in my first aid kit. Special forces use Metal windlass's idk why we only get plastic ones

  7. Best ifak list !!!!!
    1. Quickclot 2
    2. H and H gauze 2
    3. Combat gauze or celox gauze 1
    4. CAT tourniquet or SOFT tourniquet 1
    5. Isreali bandage 2
    6. Burn dressing 1

    That's enough for the first aid kit.
    You needa add more item like suture strip, tape, tincture swab etc for medical kits tho!!

  8. @darktim99 I've never been in the forces but Im into military/tactical medical kits and survivals kits. I am collecting all the goods of the US military now. For my Ifak , I dont use US Military issue ifak pack instead I used normal plastic bag to fit in my cargo pant pocket to take everywhere I go if I think I will need it.

  9. @gympar he isnt saying that is what is guranteed to happen, hes just saying that you should use it as an absolute last resort. he is right that you are likley to cause necrosis if it is on for long.

  10. In metropolitan areas, a tourniquet should not result in limb loss. You have a good window of an hour or more to get the patient to the hospital.

  11. Tourniquets do not cause tissue necrosis as rapidly as once thought. Limbs won't have to be amputated until several hours after a tourniquet is applied.

  12. thx for your videos, its comforting to learn these things especially seeing as im a 24 year old carpenter who half the time is older than the other carpenters on the job lol, and seeing as guys are constantly cutting into themselves its good to learn basic first aid. your videos are much appreciated

  13. A tourniquet should be used as a FIRST method to control life threatening bleeding. It's taken EMS this long to catch up to lessons learned from the military. A tourniquet can be used in excess of two hours with no adverse side effects. If you don't control the bleeding, they're going to die. 

  14. One important thing I want to stress here is if you do use a tourniquet, make sure you note the time. Simply write down the time on the individual's tourniquet. If you don't have a pen, use their blood and write it on their forehead. This way you know when the tourniquet been on for too long.

  15. share it with others on Facebook if you come across useful video clips or useful links web pages please share it on your Facebook and write this under the useful videos or links so others would do same

  16. 5 min on and then release. Then retighten.  Use marker to write starting time on patient to let doctors know how long it has been…..? Something like that.

  17. This video should be taken down or at least edited. Bad info. It takes a long time for amputation to be necessary after tourniquet application, which would probably never happen unless you were out where an ambulance couldn't reach you. I just watched three videos about tourniquet use, and the other two offered accurate info about that. Since this video disagreed, I decided to search for accurate info on my own. Here's a PubMed study of 455 military tourniquet use cases stating that tourniquet use is not associated with amputation. If you're inclined to trust, always TRUST BUT VERIFY.

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