Page 112 - JSOM Spring 2026

FIGURE 1 TCCC tourniquet reassessment algorithm.

ASM = All Service Member; CLS = Combat LifeSavers.

controlled with other means. Do not remove a tourniquet permanent marker to mark on the tourniquet and the ca-
that has been in place more than 6 hours unless close mon- sualty card.
itoring and lab capability are available.
• NOTE: TCCC ASM/CLS trained personnel, should not Skill Sets (Circulation/Bleeding Control)
attempt tourniquet conversion beyond 2 hours post- • Tourniquet Reassess Tourniquet Reassessment/Repositioning
application unless directed by TCCC CMC/CPP person- o May be performed by ASM (previously restricted to
nel or other advanced medical personnel. In the absence CLS, CMC, CPP)
of medical oversight, maintain the tourniquet in place and • Tourniquet Conversion to Other Hemostatic Adjuncts
continue monitoring until the casualty reaches a higher o May be performed by ASM (previously restricted to
level of care. CLS, CMC, CPP)
• Expose and clearly mark all tourniquets with the time of
tourniquet application. Note tourniquets applied and time This proposed change to the TCCC guidelines was approved
of application; time of re-application; time of conversion; by the required 75% of greater of the voting members of the
and time of removal on the TCCC Casualty Card. Use a CoTCCC.

110 | JSOM Volume 26, Edition 1 / Spring 2026