How to use a tourniquet, and other ways to stop the bleed

An active shooter. A car wreck. An accident on the soccer field. A slip-and-fall at the grocery store.

Any number of situations can lead to injuries.

And uncontrolled bleeding is the #1 cause of preventable deaths after they happen. In the most serious situations, a person can die in as little as 3 minutes.

There are a number of ways you can respond to save a life in an emergency, but only if you have the right tools.

STOP THE BLEED, a course developed by the American College of Surgeons, was created to put those tools in the hands of the public.

Here are the basics, including how to use a tourniquet:

Ensure your own safety

If you’re in an unsafe situation, get yourself to safety. If possible, take the injured person with you.

When treating a bleeding person, put on gloves if there’s time. If not, skin that’s intact (with no cuts) is a good barrier against infection. Try not to get blood in your eyes.

The ABCs of bleeding control

A — Alert 911. Even if you stop the bleeding, the victim will most likely need the help of a surgeon or other medical professional. So, call for help as soon as possible.

B — Bleeding. Find the source of bleeding. Look for continuous bleeding, a large volume of blood or pooling blood. Keep in mind that there may be multiple sites of bleeding. Also, clothing could be hiding the source of the bleeding, so feel the clothing for blood.

C — Compress. Compress to stop the bleeding by applying pressure, packing the wound or using a tourniquet.

Apply pressure to stop bleeding

For wounds that aren’t too deep, apply direct pressure to the wound, focusing on the location of the bleeding. Use just enough gauze or cloth to cover the wound. If the bleeding stops, hold constant pressure until help arrives.

Don’t lessen or remove pressure to check the wound. If you keep looking, bleeding won’t stop.

Common wound care myths busted

Packing the wound to stop bleeding

When blood is pooling inside a deeper wound, applying pressure on top of the wound won’t work to stop the bleeding. You’ll have to pack gauze or cloth inside the wound. You want to get the pressure up against the source of the bleeding.

Again, once you have the wound packed and bleeding under control, hold constant pressure on the wound, and don’t let up until help arrives.

Be careful not to drop gauze into any pooling blood, or it won’t be useful.

Using a tourniquet to stop bleeding

Tourniquets can be used on anyone except infants or very small children. Applying pressure will most often work on small children.

Generally, place tourniquets on limbs, about 2 to 3 inches above wounds, avoiding elbow or knee joints. They can pinch skin, so place over clothing if possible.

Tighten the tourniquet until the bleeding stops, then don’t remove it until help arrives, unless there’s good reason. A second tourniquet may be required to stop the bleeding.

Tourniquets hurt. The goal is to press vessels against the bone and the pulse will slow or even stop. Will this cause loss of a limb? It depends on the situation, but it’s best to keep the patient alive and worry about the limb later.

If you’re dealing with a snakebite, at least in the United States, skip the tourniquet. The toxin in the pit vipers found here goes through the body right away, and tourniquets can cause more damage than good. Your best bet is to get a good description of the snake to help the health care team find the right treatment.