How to Make an Improvised Tourniquet (And Why It’s Usually a Bad Idea)
Making a tourniquet from everyday materials is a relatively simple technique that can help to limit blood flow when there is heavy and uncontrolled bleeding from a limb. This life-saving measure may be effective when direct pressure doesn't work or when maintaining physical pressure isn't practical.
Improvised tourniquets are far less effective than commercial tourniquet devices, and they can be dangerous or even life-threatening when applied improperly. Because of this, we recommend that everyone have a commercial torsion device on hand at all times. However, if you’re dealing with uncontrolled blood loss and you don't have a commercial tourniquet available, an improvised tourniquet can be used to treat limb injuries and stem the blood loss until emergency services arrive.
How to Make a Tourniquet Step by Step
To make a tourniquet, you will need:
- A wide piece of clean cloth that is not overly stretchy (such as spandex), for applying circumferential pressure. Ideally, this should be 3 inches in width but anything above 1½ inches will work. This could be a:
- Scarf
- Bandana
- Neckerchief
- Sleeve
- Pants leg
- A rigid object for a windlass that won't snap under pressure. This could be a:
- Sturdy stick
- Broom handle (cut down)
- Closed pocket knife
- Thick, strong ballpoint pen
- Chopstick
- Something to secure the windlass, such as another piece of cloth
- A permanent marker
How to Apply an Improvised Tourniquet
Once you have called 9-1-1, gathered the necessary materials, washed your hands, and put on sterile gloves (if available), you're ready to apply a tourniquet:
- Tell the patient that you will apply a tourniquet and that it will feel uncomfortably tight but is necessary to save their life.
- Uncover the wound on the injured limb, cutting away the clothing around the wound if scissors are available.
- Position the wide piece of clean cloth 2-4 inches above the wound, or above the joint if the wound is just below the joint.
- Wind the cloth around the limb and tie one half-knot. If there is enough material, wind it around a few times for padding before tying the knot.
- Position the windlass on top of the knot and tie another half-knot to secure the windlass.
- Turn the windlass to tighten the band of cloth. Continue turning until you see the wound stop bleeding or until the bright red bleeding stops and there is only a trickle of dark-red blood oozing out.
- Secure the windlass with the second piece of cloth so that it doesn't unwind (and the tourniquet doesn't loosen).
- If the wound continues to bleed heavily, a second tourniquet can be applied under the first.
- If you know how to check a victim's distal pulse, do it now. If there is no pulse on the other side of the tourniquet, you know you have compressed the artery correctly.
- Taking the permanent marker, write the time the tourniquet was applied on the victim's forehead: "T = time."
- When emergency services arrive, tell them that the victim has a tourniquet and the time it was applied.
After applying the first tourniquet, check the victim to see whether there are more limb injuries that involve profuse bleeding and make more tourniquets as needed. In serious medical emergencies, there might be more than one patient who is experiencing severe blood loss—in which case multiple tourniquets might be needed.
When You Shouldn't Apply a Tourniquet
You should only apply a tourniquet if a few minutes of direct pressure doesn't stop the bleeding, if the bleeding is internal (such as when treating a gunshot wound) or if it's not practical to apply pressure—such as in the case of multiple injuries or multiple victims. Web stores that sell bleeding kits typically offer bulk tourniquet bundles for this purpose.
The other time you shouldn't (read: can't) apply a tourniquet is for wounds occurring on the torso, neck, or head. In this case, apply even and direct pressure and pack the wound if the bleeding slows sufficiently. Everything you need to pack or bandage a wound (including a commercial tourniquet) can be found in a bleeding control kit.
How Long Can You Leave the Tourniquet On?
Tourniquet devices can stay on for around two hours before neurovascular injury may begin to occur. They are a temporary measure to stem rapid blood loss until the wound can be cleaned and closed by a medical professional. Leaving a tourniquet on for too long can lead to serious complications from the lack of blood circulation, including amputation of the limb.
When someone experiences a traumatic injury, apply the tourniquet to control blood loss and seek immediate medical attention. You have only minutes to stop severe blood loss but a good two hours before the device needs to be removed. In the hospital, wait for a medical professional to remove the tourniquet when it's safe. You should never remove it yourself.
Materials That Should Not Be Used in an Improvised Tourniquet
When treating a traumatic wound with a tourniquet, you should avoid using a very thin material such as a cord, wire, or shoelace as they are too thin to stop blood flow, more likely to cause excessive pain, and also much more likely to cause further injury such as permanent nerve damage. You should also avoid overly stretchy materials, as these make achieving full occlusion difficult. A strip of clothing is usually the best bet if you don't have anything else.
For the windlass, make sure that the stick or other rigid object is thick and strong enough that it won't break. Craft sticks and pencils often snap under pressure, making the torsion device ineffective and putting the patient at risk of bleeding out.
Commercial Tourniquets Are Best
While it's good to know how to make a tourniquet to control bleeding in an emergency, it's much better to have a proper trauma kit with a tourniquet that you know will work. Tourniquets come in many configurations—from windlass tourniquets like the C-A-T® and SAM XT to stretch tourniquets like the SWAT-T that can be used on children and pets.
In addition to a tourniquet, bleeding control kits contain things like wound packing gauze and vented chest seals for injuries located on other parts of the body, plus a permanent marker for noting the time of tourniquet application. Don't take risks when it comes to serious medical emergencies. Get a proper bleeding kit and be prepared.
