Tourniquet Placement


Founding Member
Tourniquet placement and usage techniques in a non-emergent environment differ but are beyond the scope of this post...

Here are the four locations for tourniquet placement:​



^ BFG is good stuff. Thank you for posting that. (y)

Towards the discussion of TQ placement -

^ The following public FB post on the North American Rescue (makers of the CAT) gives a bit of nuance into the "high-and-tight" versus closer-to-wound placement discussion.

Same for the following entry appearing in the Dark Angel Medical blog:

And unlike what we previously were taught, TQs will work just fine on "two bone" compartments, such as the forearm and lower leg: NAR - two bone compartments [graphic images in this post]

A few other very important things for us civilians to remember include -

(1) For blast injuries, we should be careful to look further proximal ("towards the heart/trunk"). Even though the traumatic blast-induced amputation may be more distal (towards the end of the extremities: i.e. more towards the foot or hand), the blast may cause injuries "higher up." We've all seen that now iconic image of that injured man at the 2013 Boston Marathon, being pushed on a wheelchair while holding up his severed leg.... Going "high and tight" here may not only be the most expedient thing to do, but also may well save the victim's life. [I will come back for a citation to support this assertion, if I can find it: I read it a little while ago, and can't seem to locate the source. :giggle:]

(2) CPR is a wonderful, lifesaving technique, but if there's no blood for the heart to pump, it's a net-zero. For massive bleeds, that blood loss must be stemmed at first opportunity, and this is highlighted in the following BFG "Always Better" medical blog: https://www.blueforcegear.com/articles/post/cpr-trauma-patients-news-post.html

(3) TCCC TQs will more than likely also work on children: https://www.crisis-medicine.com/do-commercially-available-tourniquets-work-on-kids/ However, be prepared to improvise if it does not.

(4) Finally, for as awesome tools as the TCCC TQs are (I carry 2 at all times, and both my EDC/carry-on bag, as well as my vehicle and range-bags each have more), remember that what we civilians may see in "mass shootings" will differ from what is seen in armed conflicts: https://pubmed.ncbi.nlm.nih.gov/26958801/ If you can, having chest seals in your EDC-IFAK is worth the money and space premiums. That said, the statistical differences in wounding should not mean that we average-Joes/Janes forego TQs in our kits: remember that massive-bleeds as a result of traumatic injuries to the extremities are often the result of motor-vehicle, industrial, and other every-day accidents or activities.
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after having to use tqs' on several occasions, I can honestly say my decision to place 2-3 inch's higher is the reason that all 3 of my patients are able to walk on a more secure stump with a more secure prosthetic. recovery and rehab time in these three instances were benefited greatly by the chosen placement. I will also say that experience from other colleagues shows similar results from a high and tight on their incidents. with that being said I can only assume that experience with patient complexities and your current environment ( 2 hour window time to Hospital,, geography, urban, rural, combat, at sea) is your decision maker on what is best for your PT.


I was just reminded of this old article via the Active Self Protection FB feed this morning:

Just like that gun, if you're carrying a TQ for the "what if," be sure you actually know how to use it properly. (y)