Which statement correctly describes tourniquet use in extremity trauma?

Which statement correctly describes tourniquet use in extremity trauma?

• A. Indicated for life-threatening limb bleeding; place 2-3 inches above wound; record time; do not remove in field until definitive control
• B. Always avoid tourniquets
• C. Place directly over wound
• D. Remove and reapply every 2 minutes

Answer: (A)

The main idea is that a tourniquet is a life-saving measure to stop severe, uncontrolled bleeding from an injured limb when direct pressure isn’t enough or feasible, while balancing the risk of limb ischemia. The best description matches this approach: use a tourniquet for life-threatening extremity bleeding, place it 2–3 inches proximal to the wound (not directly over the wound) to effectively occlude arterial inflow, record the exact time of application, and keep it in place in the field until definitive hemorrhage control is achieved surgically. Placing the tourniquet 2–3 inches above the wound ensures the artery is compressed upstream of the injury, creating a true occlusion rather than trying to compress over the damaged area. Placing it directly over the wound undermines occlusion, can worsen tissue injury, and makes assessment and rebleeding control harder. Recording the application time is crucial because the duration of limb ischemia correlates with tissue damage, and it helps the receiving team decide on definitive care. Finally, removing or loosening a tourniquet in the field before surgical control can lead to a dangerous rebound bleed; it’s typically left in place until the patient is under definitive hemorrhage control in a controlled setting.

The main idea is that a tourniquet is a life-saving measure to stop severe, uncontrolled bleeding from an injured limb when direct pressure isn’t enough or feasible, while balancing the risk of limb ischemia. The best description matches this approach: use a tourniquet for life-threatening extremity bleeding, place it 2–3 inches proximal to the wound (not directly over the wound) to effectively occlude arterial inflow, record the exact time of application, and keep it in place in the field until definitive hemorrhage control is achieved surgically.

Placing the tourniquet 2–3 inches above the wound ensures the artery is compressed upstream of the injury, creating a true occlusion rather than trying to compress over the damaged area. Placing it directly over the wound undermines occlusion, can worsen tissue injury, and makes assessment and rebleeding control harder. Recording the application time is crucial because the duration of limb ischemia correlates with tissue damage, and it helps the receiving team decide on definitive care. Finally, removing or loosening a tourniquet in the field before surgical control can lead to a dangerous rebound bleed; it’s typically left in place until the patient is under definitive hemorrhage control in a controlled setting.