What is the correct sequence for applying a combat tourniquet?

• A. Place 2-3 inches above wound, secure tightly, tighten until bleeding stops, record time of application
• B. Place above wound, tighten until bleeding stops, secure tightly, record time of application
• C. Place 2-3 inches above wound, record time of application, secure tightly, tighten
• D. Place below the wound, secure tightly, tighten until bleeding stops, record time of application

Answer: (A)

The main idea is to occlude the bleeding by placing the tourniquet correctly and documenting its use. You want to position the device about 2-3 inches above the wound on bare skin so the pressure sits on solid soft tissue and can compress the artery before it reaches the injury. Secure the tourniquet first so it won’t slip when you tighten, then tighten until the bleeding stops (or until you no longer have distal bleeding/pulse). Finally, note the time of application so responders know how long the tourniquet has been in place. This order prevents placing the device in the wrong spot, ensures effective occlusion, and provides crucial timing for ongoing care. Placing the tourniquet below the wound wouldn’t stop arterial flow to the injury, and recording the time before achieving occlusion or skipping the tightening step would leave the injury inadequately controlled.