How should a tourniquet be applied for extremity hemorrhage?

• A. Apply proximal to the wound, above the injury; tighten until bleeding stops or flow returns; record time; do not remove unless trained.
• B. Apply distal to wound; loosen after 2 minutes.
• C. Apply around the limb and twist once; remove immediately after bleeding stops.
• D. Apply at the wound edge and monitor heartbeat.

Answer: (B)

When stopping life-threatening bleeding from an arm or leg, the key is to cut off the blood supply right above the wound with a tourniquet and keep it tight until medical help arrives. Proximal placement (above the wound) ensures arterial flow to the injured area is blocked, which is what quickly halts severe bleeding. You tighten firmly until the bleeding stops or you can no longer feel a distal pulse, then you read the time the tourniquet was applied so responders know how long it’s been in place. Do not remove the tourniquet unless you’re trained to do so; removing it too early can lead to a dangerous rebleed when circulation returns.

Understanding why this works helps: a tourniquet works by compressing the vessels feeding the wound, not by squeezing from the side or from below the injury. Loosening after a brief moment defeats its purpose, and applying it distal to the wound wouldn’t stop the arterial bleed at the source. Techniques that involve twisting and then removing immediately, or placing the tourniquet at the wound edge, do not reliably control hemorrhage and are not recommended. The correct approach is sustained, proximal application with tight compression and careful timing for transport.