How to Make an Improvised Junctional Tourniquet + Safer Alternatives
Severe injuries located at the junctional areas of the body—including the groin, armpits, and neck—require junctional tourniquets for hemorrhage control. A junctional tourniquet is a device designed to stop severe bleeding in the junctions of the body.
Making an improvised junctional tourniquet allows first responders to apply direct pressure to an injury, control bleeding, and secure wound packing in place in an emergency if a commercial junctional tourniquet is not available. However, improvised junctional tourniquets are not anywhere near as reliable or safe as commercial junctional tourniquets.
Improvised Junctional Tourniquet Materials
If you don’t have a commercial junctional tourniquet on hand, gather the following materials as quickly as possible:
- A strong, wide belt or cloth at least two inches wide (OR two limb tourniquets)
- Pressure delivery devices such as shoes, boots, or a strong water bottle
- A sturdy stick, strong ballpoint pen, chopstick, or other strong, similar object to use as a windlass (the same kind of object you would use for a windlass when making an improvised tourniquet)
- Padding, such as clean clothing, towels, or gauze
- Tape or a securing device
Steps to Make an Improvised Junctional Tourniquet
Follow these steps to make an improvised junctional tourniquet. Act quickly as every second counts. A victim can bleed to death from a massive hemorrhage in as little as two to five minutes.
- Find the junctional injuries and have another person call the emergency medical services (EMS).
- Pack hemostatic gauze like the QuikClot Bleeding Control Dressing or wound packing gauze (or clean towel if all that is available) directly into the bleeding site while preparing the improvised tourniquet. Learn how to pack a wound with our written guide and preferably a Stop the Bleed course before a bleeding emergency occurs to master the technique.
- Place the pressure delivery device (PDD) on top of the blood vessel that is bleeding.
- The PDD in improvised inguinal junctional tourniquets should be placed in the inguinal gutter. This is the area where you can feel the femoral pulse about halfway between the hip and the spine on the front side of the body.
- For armpit injuries, place the pressure delivery device as high in the armpit area as possible.
- For injuries at the base of the neck, place the pressure delivery device between the wound and the heart.
Continue to apply direct pressure to the wound. - Position a belt, cloth, or two joined limb tourniquets around the body, bleeding site, and PDD. The correct placement for the belt is:
- Around the pelvis for groin injuries.
- Around the torso and opposite shoulder for axilla (armpit) injuries.
- Around the torso and opposite shoulder for neck injuries.
- Add the windlass by setting it on top of the belt, cloth, or limb tourniquet.
- Tighten. Wrap the cloth or belt around the windlass and twist the windlass to tighten. If using limb tourniquets, simply twist the incorporated windlass which is already attached to the tourniquet. Keep twisting until the bleeding stops. If possible, use a second belt or piece of cloth over the first for the windlass so that you don’t pinch the skin.
- Secure the windlass in place using tape, cloth, or a limb tourniquet device.
- Write down the time the tourniquet was placed on the victim. Share this information with the emergency providers when they arrive.
- Monitor the injury for continued bleeding and tighten the tourniquet if needed (don’t loosen it or take it off).
Commercial Junctional Tourniquets
A professionally designed junctional tourniquet is much stronger, more effective, and more reliable than an improvised junctional tourniquet. It’s a good idea to purchase and carry commercial tourniquets with you to be ready for a bleeding emergency. A significant junctional hemorrhage can quickly produce heavy blood loss and having one of the following junctional tourniquets on hand could save lives.
SAM Junctional Tourniquet
The SAM junctional tourniquet is one of the top tourniquets recommended by the Committee on Tactical Combat Casualty Care (CoTCCC) for junctional hemorrhage control. Its belt compresses the pelvic or axilla (armpit) regions with inflated targeted compression devices to apply direct pressure to the broken blood vessel.
The SAM junctional tourniquet can be employed in as little as 25 seconds. This extremely quick application time allows for greater survival in civilian emergencies as well as in the military, including special operations forces.
Combat Ready Clamp (CRoC)
This professional junctional tourniquet has a mechanical advantage lever that can be applied at the desired pressure point to add extra pressure directly to the wound. This tourniquet can be applied to both the axilla and groin areas.
Junctional Emergency Treatment Tool (JETT)
Inflatable bladders are used to provide direct pressure to hemorrhages in the groin or axilla areas. Tighten the compression pads until blood flow stops and the distal pulse is not felt. Bleeding should stop within 90 seconds when using the JETT.
FAQs
What are the Junctional Areas of the Body?
The junctional areas include the:
- Groin: This is the area where the leg and pelvis meet.
- Armpit: This is the area where the arm and shoulder meet.
- Neck: This is the area where the neck and shoulder meet. The neck is an extremely difficult area to treat due to the risk of airway closure.
What Is a Junctional Hemorrhage?
A junctional hemorrhage occurs when the large blood vessels that pass through the junctional areas of the body are injured. Junctional tourniquets are intended to stop blood flow through injured large blood vessels via direct external pressure. Junctional tourniquets are composed of a pressure delivery device (PDD) and a belt or strap that holds the pressure device in place.
How Do You Treat Junctional Hemorrhage?
Our junctional hemorrhage control overview describes in detail the three steps to take when dealing with junctional bleeding:
- Apply direct pressure.
- Pack the wound.
- Apply a junctional tourniquet.
These three steps help first responders stop bleeding as quickly as possible by using the correct form of pressure delivery to the broken veins or arteries.
The Verdict on Improvised Junctional Tourniquets
An improvised junctional tourniquet can be fashioned using everyday materials in a bleeding emergency when commercially marketed junctional tourniquets are not available. However, there are many variables that can go wrong when making a tourniquet on the fly in a high-stress situation. For this reason, it is not recommended to use an improvised junctional tourniquet unless absolutely necessary.
The safest option is to have a professionally made junctional tourniquet (such as the SAM junctional tourniquet) ready to go at a moment's notice. This medical device is precise, easy to use, reliable, and adjustable. This increases the victim’s chances of survival. Using a commercial tourniquet saves precious time and energy that can be focused on quickly stopping the bleeding.
An improvised junctional tourniquet should be seen as a temporary measure to reduce serious blood loss when a commercial junctional tourniquet is not available. Call for professional help as soon as possible.
