Preparation and Setup of the Tourniquet


Disclaimer:  These are only suggestions or proper set up and wear of the combat tourniquet.  All personnel using a tourniquet should consult their medic, doctor, healthcare provider and tourniquet manufacturer on the proper wear, setup and use of the tourniquet prior to use.

After seeing countless soldiers walking around in combat zones, improperly wearing their tourniquets, we though we would put together a quick guide to getting your kit set up properly.  Soldiers are often handed tourniquets and given no instruction on its proper wear or use and then take that piece of kit into combat under the notion that they will figure it out when the time comes.  Unfortunately, the tourniquet, like any other piece of life saving equipment  is something that you have to pragmatically approach in setup and use.  This is especially important when you consider that an arterial bleed can cause someone to lose consciousness in 15 seconds and completely bleed out in 30-45 seconds.  If operators are not actively practicing the use of applying the tourniquet from their kit then they should consider making it a part of their training plan.  Below is a simple guide on how to properly setup and place a combat tourniquet on your gear.

 

Step 1- The Setup

The setup of your tourniquet is crucial in ensuring it can be quickly placed onto the injured limb.  Under no circumstances should soldiers be walking around theater with the plastic wrap still covering their tourniquets or if they haven’t properly set up the tourniquet for immediate use.

Inspection: When you are first issued a tourniquet you should inspect its components for cracks, tears or deformities.  This is especially important for users living in dry, hot, desert environments that cause the plastics to break easily.

Preparation:  After inspecting the tourniquet you should prepare it for immediate deployment.  The idea behind the set up is to make the tourniquet so that it can be used with one hand in the event that it needs to be applied to one of your arms.

Always check the tourniquet for cracks, tears or deformities before use

To prepare the tourniquet for employment first weave the tourniquet strap through ONE loop on the attached buckle.  This will allow you to cinch the tourniquet down using one hand.  If you weave through both buckles you will not be able to cinch the tourniquet down quickly.  Once the tourniquet is cinched down and the velcro has been adhered to itself there will be enough friction to keep it from moving.

weave the end of the tourniquet through one loop on the buckle so that it can be cinched down with one hand

Sizing: Size the tourniquet so that it is open/wide enough to fit over your largest extremity (usually your leg) as well as fit over any equipment you might have on such as a drop leg holster or boots.  The tail end should be very short since it will be adhered to the velcro on the tourniquet, if this tail is too long and adhered to too much velcro you will not be able to grab it and cinch it down using one hand.

Size the tourniquet so that it can fit over your largest extremity of piece of equipment on your body.

Take the tail end of the tourniquet and fold it over on itself, creating a small tab for you to grab.  This is important given that if you are using the tourniquet, your dexterity will be limited due to gloves, blood or dirt.

 

Finally “S” roll the tourniquet onto itself so that it will open when pulled from your kit.

"S" Roll the tourniquet for ease of employment

Step 2 – Placement:

Placing the tourniquet on your kit is as equally as important in ensuring you can employ it in a timely manner.  Many soldiers downrange place their tourniquets in their top right or top left cargo pocket of their duty uniform; this should be avoided considering that if the opposite arm in which the tourniquet is being carried becomes injured it would not be able to reach up and grab the tourniquet from the pocket.  All tourniquets should be placed where both hands can easily reach them and release with minimal effort!

One of the most important things when considering placement of the tourniquet is ease of employment.  Rubber bands, tourniquet holders and even hair ties are great ways of keeping your tourniquet on your kit while still being able to rip it off when needed.  Note: If using rubber bands or hair ties to keep your tourniquet on your kit always ensure you replace them every few days.  Rubber bands will easily break, especially when left out in the elements.

A few common places for your tourniquet include: the middle of your plate carrier, behind your back centered on your belt, lower left or right pant leg cargo pocket, buttstock of a rifle, inside a vehicle door handle and on the outside of the aid bag.  I personally keep two tourniquets on my persons at all time, one on my tourniquet holder located behind my back on my belt and the second in my lower cargo pocket pants leg.  The reason I keep these in the said locations is to ensure that one, I have a tourniquet on my persons at all time and two, I have more than one tourniquet on me at all times in the event that I need to apply it to two extremities or to another casualty.

Placing the tourniquet on your body armor:

The REFT tourniquet Holder

Placing the tourniquet on your belt (best option for low vis operations):

Placement on rifle:

When placing tourniquets on a buttstock ensure that it does not hinder with charging handle operation or a proper cheek weld.

Placement in pocket:

When placing tourniquets in pocket ensure that it can be reached by both hands.

 

In short, when you need to use your tourniquet you have the rest of your life to figure out if you set it up properly or not.  To ensure a quick application operators should always practice taking their tourniquet from their kit and applying it to their different extremities in 30 seconds or less.  We try to incorporate the placement of tourniquets into our stress shoots and combat scenarios to ensure each operator has the proper set up.

Items featured in blog:

RE Factor Tactical Tourniquet Holder- http://blog.refactortactical.com/products/medical/tourniquet/

RE Factor Tactical Trauma Shear Holster- http://blog.refactortactical.com/products/medical/trauma-shears/

RE Factor Tactical Combat Reference Guide- http://blog.refactortactical.com/products/direct-action/combat-reference-stickers/

RE Factor Tactical Kydex Operator Holster- http://blog.refactortactical.com/products/kydex-holsters/kydex-holster/

Marz Tactical Gear Plate Carrier-  http://blog.refactortactical.com/products/plate-carriers/marz-tactical-gear-plate-carrier/

CAT Tourniquet- http://www.combattourniquet.com/

North American Rescue Trauma Shears- http://www.narescue.com/NAR_Trauma_Shears-CN1CEED1D0349C.html