Which sign indicates a tourniquet may have been left on too long?

• A. Increasing pain
• B. Numbness
• C. Pale extremity
• D. Increasing pain, numbness or tingling, pale or cold extremity, loss of distal pulse or motor function

Answer: (D)

Ischemia from a tourniquet left on too long shows up as signs of compromised blood flow and nerve function. When a tourniquet is too tight or stays in place too long, tissues beyond the belt are starved of oxygen, and nerves react with pain and sensory changes, while the skin and distal parts become cold or pale and the pulse and movement can fail.

The best option describes the full range of indicators: increasing pain, numbness or tingling, a pale or cold extremity, and loss of distal pulse or motor function. These collectively signal that perfusion is severely restricted and ischemia is progressing, which requires urgent reassessment of the tourniquet management.

The other options mention individual signs, but none alone captures the complete warning pattern. Recognizing the full combination helps you identify when to reevaluate and adjust the tourniquet to balance hemorrhage control with limb viability.