PERFORMANCE CHECKLIST
APPLY AN IMPROVISED TOURNIQUET TO AN EXTREMITY
Situation: You have decided to apply an improvised tourniquet to a casualty
(wound/amputation site marked or indicated). Apply the tourniquet now and prepare the
casualty for transport. However, do not tighten the tourniquet all the way. Tell the
evaluator what you would do at that point, then continue as though the tourniquet band
were tightened appropriately.
.
Supplies: Triangular bandages (or other material appropriate to make a cravat and
secure the rigid object), windlass (stick), tape, marking device.
GO
NO-GO
Makes a band (cravat) at least two inches wide.
_____ _____
Wraps the tourniquet band around the limb two to four inches.
_____ _____
above the wound.
Ties a half-knot.
_____ _____
Places the rigid object (stick) on top of the half-knot.
_____ _____
Ties a full knot over the rigid object.
_____ _____
Twists the stick to tighten the tourniquet. [Simulate if practicing
_____ _____
on a person.]
Secures the windlass to prevent tourniquet from untwisting using
_____ _____
strip of cloth, cravat, or tape wrapped around the limb. If a cravat
or strip of cloth is used, the tails are tied in a nonslip knot.
Marks the casualty's forehead with a "T" and the time of application.
_____ _____
OVERALL EVALUATION
GO
NO GO
(A no-go on any step gives an overall evaluation of no-go.)
IS0877
5-41
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