What is the rule for tightening a tourniquet?

The correct approach for tightening a tourniquet is to constrict it only until the bright red bleed has stopped. This practice ensures that the tourniquet is applied effectively to control life-threatening bleeding while also reducing the risk of potential complications associated with excessive tightness.

The intent behind this rule is to apply the tourniquet tightly enough to occlude blood flow and halt arterial bleeding, indicated by the bright red color of the blood. If the bleeding stops and the tourniquet has been appropriately applied, it indicates that it is exerting the necessary pressure. Tightening beyond this point is not advised as it can cause unnecessary tissue damage and complicate further medical treatment.

Inappropriate approaches such as tightening it as much as possible without regard to the bleeding status can lead to extreme pressure that damages underlying tissues. Similarly, reliance on the presence of a distal pulse can result in under-tightening, potentially allowing continuous bleeding to occur. Lastly, maintaining pressure until the wound stops oozing can be misleading, as some bleeding may still persist without adequate pressure being applied. Thus, the focus on bright red blood serves as a clear and practical guideline for effective tourniquet use in emergency situations.