Tourniquets Explained Properly

How modern bleeding control has evolved and why it saves lives

Severe bleeding can cause death in minutes. In those first critical moments, the actions of the people present matter more than anything else.

Tourniquets are now recognised as one of the most effective tools for stopping life threatening bleeding from limbs. However, this has not always been the case. For many years, tourniquets were misunderstood, misused, and avoided. Understanding how they evolved helps explain why they are now an essential part of modern first aid training.

At DTMK Training Services, catastrophic bleeding management forms an important part of our regulated first aid training in Milton Keynes and the surrounding counties. Proper understanding of tourniquet use gives people the confidence to act quickly and effectively when it matters most.

The early history of tourniquets. When misunderstanding limited their use

Tourniquets have existed for centuries and were widely used in early battlefield medicine. Unfortunately, they were often applied incorrectly.

Common problems included applying them too loosely, placing them in the wrong position, or using narrow materials that caused tissue damage without stopping bleeding. In many cases, bleeding continued despite the tourniquet being in place.

As a result, tourniquets developed a poor reputation. They became associated with harm rather than survival, and for many years first aid teaching focused almost entirely on direct pressure.

Direct pressure remains the first and most important intervention for most bleeding. However, experience has shown that it is not always enough to control catastrophic haemorrhage.

The turning point. Battlefield evidence and modern tourniquet design

Modern military conflicts provided clear evidence about catastrophic bleeding and survival.

Medical teams observed that many preventable deaths were caused by severe bleeding from arms and legs. When tourniquets were applied quickly and correctly, survival improved significantly.

This led to the development of modern tourniquet designs, including the Combat Application Tourniquet, often referred to as the CAT.

Modern tourniquets include:

• Wide bands that apply pressure safely

• A windlass mechanism that allows controlled tightening

• Reliable application even in high stress situations

• The ability to stop arterial bleeding effectively

This marked a major shift in medical understanding. Tourniquets were no longer seen as dangerous. They were recognised as essential life saving equipment.

Today, they are standard equipment for ambulance clinicians, military medics, and first aiders trained in catastrophic bleeding control.

Modern UK clinical guidance. What JRCALC and Qualsafe teach

Current UK prehospital guidance, including JRCALC and regulated first aid training such as Qualsafe Awards courses, teaches that catastrophic bleeding must be controlled immediately using the most effective method available.

The priority is always to stop life threatening blood loss as quickly as possible.

This may involve:

• Direct pressure to the wound

• Application of a trauma dressing

• Use of haemostatic dressings where direct pressure alone is insufficient, particularly in areas where tourniquets cannot be used

• Application of a tourniquet for severe bleeding from limbs

Tourniquets are the preferred and most effective treatment for catastrophic bleeding from arms or legs.

Haemostatic dressings are especially useful for bleeding in junctional areas such as the groin, armpit, or neck, where a tourniquet cannot be applied.

The correct intervention depends on the location and severity of the bleeding. The priority is always rapid and effective control.

What is inside a public access bleed control kit

Public access bleed kits are increasingly available in public spaces across the UK, often located alongside defibrillators.

These kits are designed to allow immediate intervention before ambulance crews arrive.

A typical public bleed control kit includes:

• A Combat Application Tourniquet or equivalent

• Haemostatic dressings

• Trauma dressings

• Compression bandages

• Protective gloves

• Trauma shears

• Clear instructions

These kits are designed specifically for catastrophic bleeding, not minor injuries.

When a tourniquet should be used

Tourniquets are used for severe, life threatening bleeding from a limb when bleeding cannot be controlled quickly and effectively with direct pressure.

This includes bleeding that is:

• Heavy and continuous

• Spurting or pulsating

• Not controlled with firm pressure

• Associated with amputation or severe trauma

If bleeding stops with pressure alone, a tourniquet is not required.

If bleeding continues despite firm pressure, applying a tourniquet can save a life.

Where to place a tourniquet

Correct placement is essential for a tourniquet to work effectively.

A tourniquet should be applied:

• Directly to the limb

• 5 to 7 centimetres above the wound

• Between the wound and the torso

• Not over a joint

If the wound cannot be clearly identified, or there are multiple injuries, the tourniquet should be placed high on the limb.

For severe bleeding from the lower arm or lower leg, applying the tourniquet to the upper arm or upper thigh is appropriate if rapid control is required.

The aim is simple. Stop the bleeding completely.

How a tourniquet works

A tourniquet works by compressing blood vessels against the underlying bone, stopping blood flow beyond the point of application.

The tourniquet should be tightened until bleeding stops completely.

This will be uncomfortable or painful for the casualty. This is expected and indicates that sufficient pressure has been applied.

A loosely applied tourniquet is ineffective and allows continued blood loss.

Modern tourniquets are designed to allow secure and controlled tightening.

What happens after a tourniquet is applied

Once applied, the tourniquet must remain in place.

It must not be loosened or removed by a first aider.

Emergency medical services must be called immediately by dialling 999.

The time of application should be noted and passed to the ambulance crew.

The tourniquet stabilises the casualty by preventing further blood loss until definitive medical care is available.

Ambulance clinicians and hospital teams will then manage ongoing treatment safely.

Are tourniquets safe

Modern evidence and clinical experience clearly show that tourniquets are safe when used correctly and for appropriate situations.

The risk from uncontrolled bleeding is far greater than the risk from tourniquet use.

Tourniquets are now standard equipment across emergency medical services and are taught as part of regulated first aid training.

Their correct use saves lives.

Why bleeding control training matters

Most deaths from catastrophic bleeding occur before emergency services arrive.

This means the actions of bystanders are often the deciding factor.

Proper training ensures people know:

• When to apply pressure

• When to use a tourniquet

• How to act confidently

• How to keep someone alive until help arrives

These skills save lives.

First aid training in Milton Keynes and surrounding counties

At DTMK Training Services, we deliver regulated first aid training in Milton Keynes, Buckinghamshire, Bedfordshire, and Northamptonshire.

Our courses follow current UK clinical guidance and provide practical, hands on training using professional equipment.

We teach catastrophic bleeding management, including the safe and correct use of tourniquets, as part of our:

• Emergency First Aid at Work courses

• First Aid at Work courses

• Paediatric First Aid courses

• Community first aid training

• Bleeding control and trauma awareness sessions

  
  

Our aim is to ensure more people have the skills and confidence to save a life.

Learn life saving skills with DTMK Training Services

Emergencies are unpredictable. Training ensures you are ready.