Official OCEMS site ↗
← Clinical guides

BLS · Adult & pediatric · BLS / ALS

Tourniquet: uncontrolled extremity bleeding

Apply an approved tourniquet, keep it visible, and communicate the placement time.

OCEMS source summary · Updated 2026-09-16

Key cautions & base contact

  • The device must remain visible during transport and handoff.
  • Placement requires an ALS-level response under B-010.

When to use it

  • B-010 indicates a tourniquet for upper- or lower-extremity hemorrhage that cannot be controlled with direct pressure or a pressure dressing.
  • Use appropriate blood-exposure PPE and an approved device. Inspect the injury and assess distal circulation, motor function, and sensation.

Place & tighten

  • Apply proximal to the wound, usually 2–4 inches above it under this source. Avoid placing over a joint, angulated/open fracture, or the stab/gunshot wound itself.
  • Tighten to the pressure needed to stop bleeding. Cover the wound with an appropriate sterile dressing or bandage.
  • Leave the tourniquet visible; do not cover it with the wound dressing.

Reassess

  • Reassess distal circulation, motor function, and sensation and the effectiveness of bleeding control. Record vital signs and the application time.
  • An ALS response is required when a tourniquet is placed. Continue the applicable trauma assessment and destination pathway.

Handoff

  • Tell the receiving team where the device is and exactly when it was applied; make that information visible in the report and documentation.
  • Use the amputation standing order for care of an amputated part. This page describes the B-010 tourniquet procedure, not every trauma-management task.