Page 188 - 2026 SMOG

JUNCTIONAL TOURNIQUET APPLICATION
Clinical Indications
• High-level amputation not amenable to a standard tourniquet, non-compressible hemorrhage in
a transition zone (inguinal and axillary), and pelvic immobilization.
Contraindications
• None
Procedure
All medical personnel should be proficient in deploying and applying all available tourniquets.
Junctional tourniquets (JT) should be preset and removed from wrapping (ready for immediate
use and application). Junctional tourniquets should be applied according to the manufacturer’s
instructions.
• Remove clothing as necessary to visualize the area of application if possible. Remove objects
from the patient’s pockets or pelvic area. Slide the device into place as necessary to the proper
position.
• Tighten the tourniquet by twisting or pumping up the balloon/bladder until bleeding stops.
(depends on JT used)
• Secure all straps in order to ensure the security of the device.
• Document the presence of a tourniquet and the time of placement on the patient (forehead).
(³T' signifies tourniquet). Do not cover the tourniquet.
• Recheck the tourniquet intermittently (q15min) and after any movements to ensure no new
bleeding/loosening has occurred.
• If using a JT with the pump device, additional inflation may be necessary with changes in
altitude.
• The uniqueness of junctional tourniquets does not lend itself to conversion well and
should be left to Roles with surgical capability. Use caution if attempting Junctional
Tourniquet Conversion. Must have a high index of suspicion that the injury is
compressible and can be managed by more appropriate adjuncts.
**Document procedure, results, and vital signs.**
Revised/reviewed March 2025 IAW current published JTS TC3 CPG guidelines and (High Bilateral)
Amputations and Dismounted Complex Blast Injury, 05 August 2024.

180 • PROCEDURES