Page 39 - Journal of Special Operations Medicine - Spring 2015
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stopped. When possible, a distal pulse should be of Defense Trauma Center of Excellence. The authors
checked. If bleeding persists or a distal pulse is also thank the Department of Defense Trauma Registry
still present, consider additional tightening of the for providing much of the casualty data discussed in this
tourniquet or the use of a second tourniquet side paper.
by side with the first to eliminate both bleeding
and the distal pulse.
d. Limb tourniquets and junctional tourniquets Disclaimers
should be converted to hemostatic or pressure The opinions or assertions contained herein are the pri
dressings as soon as possible if three criteria are vate views of the authors and are not to be construed as
met: the casualty is not in shock; it is possible to official or as reflecting the views of the Department of
monitor the wound closely for bleeding; and the the Army or the Department of Defense. This recom
tourniquet is not being used to control bleeding mendation is intended to be a guideline only and is not
from an amputated extremity. Every effort should a substitute for clinical judgment.
be made to convert tourniquets in less than 2
hours if bleeding can be controlled with other Disclosures
means. Do not remove a tourniquet that has been
in place more than 6 hours unless close monitor- The authors have no financial disclosures.
ing and lab capability are available.
e. Expose and clearly mark all tourniquet sites with
the time of tourniquet application. Use an indel References
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TCCC Limb Tourniquet Guidelines Change 14-02 29
