How to Apply a Tourniquet With One Hand

how to apply tourniquet with one hand

Most commercial tourniquets are designed to accommodate one-handed operation. In a traumatic bleeding emergency, you won’t always have someone else around who can apply the tourniquet to your hemorrhaging limb. It’s very important to understand how to stop the bleeding on your own before emergency services arrive.

How to Apply a Windlass-Style Tourniquet One-Handed

The most common types of tourniquets you’ll encounter are windlass-style tourniquets, which contain a strap that wraps around the limb and a rod (the windlass) that you can twist to tighten the strap. Some of the most common windlass-style tourniquets include the Combat Application Tourniquet® (C-A-T®) by North American Rescue® and the SAM XT Tourniquet by SAM® Medical. 

These types of tourniquets usually have a band and buckle. The band is fed through the buckle, creating a loop through which you can insert the injured limb. Then it’s just a matter of tightening the tourniquet firmly enough to occlude blood flow. This is done with the help of the windlass.

To apply a windlass-style tourniquet with one hand: 

  • Retrieve the tourniquet and loosen the loop (if necessary). 
  • Slide your injured arm through the loop. Position the tourniquet at least 2 to 3 inches above the injury site. 
  • Pull the strap with your free hand to tighten the tourniquet around the limb. Fasten the strap utilizing the hook and loop velcro with the C-A-T tourniquet, and by pulling the strap back on itself once the buckle stops with the SAM XT Tourniquet.
  • Twist the windlass until the bleeding stops. You’ll need to apply considerable pressure, and the tourniquet should feel uncomfortable. 
  • Wrap the attached time strap around the windlass and band, securing everything in place. 
  • Write the time of application on the time strap.

Once you’ve applied the tourniquet, observe the limb for additional signs of blood flow. You want to check for both visible blood flow and distal pulse. If bleeding continues or you detect a distal pulse, try re-tightening the strap. If that doesn’t work, continue to apply direct pressure against the wound with a dressing or clean cloth until help arrives.

How to Apply a SWAT-T Tourniquet One-Handed 

The SWAT-T tourniquet is a sophisticated and yet simple modern tourniquet designed for the lay user. It’s an excellent option for smaller limbs (effective for children and service animals), but it can work effectively on any injured limb. Rather than using a traditional strap and windlass, it consists of a simple stretchable wrap.

To apply the SWAT-T tourniquet with one hand: 

  • Hold one end of the SWAT-T tourniquet between your teeth. 
  • Use your uninjured hand to pull the opposing end of the SWAT-T and wrap it around the injured limb, at least 2 to 3 inches above the bleeding site. 
  • While still holding the end of the tourniquet between your teeth, continue to wrap the tourniquet repeatedly around the limb, stretching it firmly as you circle the injured area. The visual diamonds on the tourniquet should turn into squares to indicate that you’re stretching firmly enough. 
  • When you can’t wrap anymore, tuck the end of the tourniquet underneath itself and then release the opposing end of the tourniquet from between your teeth.

One nice thing about the SWAT-T is that it makes an effective tourniquet but can also function as a pressure dressing and elastic wrap.

What to Do When a Bleeding Emergency Occurs 

Traumatic bleeding is one of the top preventable causes of death. When this type of hemorrhaging occurs, a tourniquet can literally be a lifesaver—but it’s just one step in a much bigger life-saving procedure.

  • Get to a safe location if necessary. 
  • Apply direct pressure to the wound. Use compressed gauze to wrap the injury or an Emergency Trauma Dressing to apply direct pressure. If you don’t have a dressing available, you can use any clean cloth. 
  • Call 9-1-1. If you only have one hand available to apply direct pressure, place the phone in speaker mode. Make sure that emergency services are on their way. 
  • Apply the tourniquet. Even if you can only slow the rate of blood flow, it should buy you enough time for emergency services to intervene. 

General Precautions When Applying a Tourniquet One-Handed

If you do fall victim to a bleeding emergency and need to apply a tourniquet with one hand, it’s important to heed the following:

  • If you can’t determine the exact location of the bleed, the general rule is to apply the tourniquet high on the limb, above the general injury site. Just make sure not to place the tourniquet over a joint such as an elbow. 
  • Make sure that the tourniquet is extremely tight. As a general rule, you should not be able to slide three fingertips between the tourniquet and the injured limb. 
  • Do not attempt to use an improvised tourniquet unless you have uncontrolled severe bleeding and no commercial tourniquet is available. If you have no choice but to make an improvised tourniquet from household items, make sure that you understand how to make an improvised tourniquet that actually works (without worsening your injury). 
  • If a tourniquet alone is unable to stop the bleed, you might need to apply a second tourniquet (if available). Otherwise, continue to apply direct pressure to the injury site until emergency services arrive. 

Finally, it’s important to understand that a bleeding emergency can happen to anyone. If you haven’t already done so, consider investing in a good bleeding control kit. Hopefully you’ll never need to use it, but if you do, it just might save your life.

Brian Graddon
Article written by

Brian Graddon

Brian is a former Firefighter Paramedic who also worked as a SWAT Medic, Engineer, and Captain over a 15-year career. Brian is devoted to providing life-saving information based on his first hand experience in life-saving application of tourniquets, hemostatic gauze, chest seals and other bleeding control products.

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