a. Gather Materials for Making a Tourniquet.
(1) Tourniquet band. You need a band of strong, pliable material that is at
least two inches wide when folded and will retain this width after being tightened. A
folded muslin bandage (usually called a cravat), a folded handkerchief, or a folded strip
of clothing will do. A belt, rope, strap from LBE (load bearing equipment), roller gauze,
or a torn sleeve can also be used. Do not use wire or shoestrings as a tourniquet band.
A wide tourniquet will protect the tissue beneath the tourniquet when it is tightened. If a
very narrow tourniquet is used, the nerves and blood vessels beneath the tourniquet
may be seriously damaged.
Figure 5-11 illustrates how to fold material into a cravat. The square
material is cut in half along the diagonal (base) to form two triangular
bandages. Each triangular bandage can be made into a cravat.
(2) Rigid windlass. A strong, rigid windlass is needed to tighten the
tourniquet band. Such a windlass is shown in figure 5-12.
(3) Securing materials. Additional material is needed to secure the rigid
windlass once the tourniquet band has been tightened. A piece of cloth or cravat similar
to the tourniquet band can serve as securing material.
b. Select the Tourniquet Site. Select a site two to four inches above the edge
of the wound or amputation site.
(1) If the wound or amputation site is in the upper arm or thigh, select a site
that is two to four inches above the edge of the wound or amputation site.
(2) If the wound or amputation is below the elbow or knee, initially select a
site two inches above the edge of the wound or amputation site. If an improvised
tourniquet applied below the knee or elbow is unsuccessful at stopping the bleeding,
apply a second tourniquet two to four inches above the joint (knee or elbow). Do not
remove the first tourniquet until the second tourniquet has been applied.
Do not place a tourniquet over a joint or over a fracture site.
c. Apply the Tourniquet.
Place the tourniquet band material around the tourniquet site.
(2) Tie the band with a half-knot (the same as the first part of tying a shoe)
(figure 5-12 A).
Place the windlass on top of the half-knot.
Tie a full knot (square knot) over the windlass (figure 5-12 B).