In Part 1 of this little series about Improvised TQs, I talked about why they often don’t work well to control bleeding.
If you haven’t read that article, I suggest going and checking it out before reading this one, so you know the limitations of improvised tourniquets.
But even though they aren’t very trustworthy, knowing how to make your own TQ is a great skill to have and something you should always have floating around in the back of your mind.
There’s no substitute for having quality medical gear like a CAT or SOF-T Wide at the ready. Bleeding out can happen in as little as 2:30 seconds so time is not on our side, and the ability to whip out a tourniquet and tie it on in a few seconds is important.
But we can’t be carrying everything we own all the time and you might be somewhere without a trauma kit. Or, you could have your trauma kit but have more than one casualty who requires a TQ to stay alive.
Exhausting your medical resources is common problem in emergency medicine and knowing how to supplement it by making your own might come in handy one day.
Here’s how combat medics are taught to construct a tourniquet:
Step one: Locate the materials.
The strap can be any cloth material you can find, but stay away from anything elastic as it will take forever to tighten down and it could cause additional nerve and tissue damage at the sight of the TQ.
Make sure the strap is between 2 – 1.5 inches wide, and long enough to be tied around the limb. It’s better to make it too long than too short. Cutting a strip of fabric from the casualty’s Levi’s is a great way to quickly have a robust TQ strap.
The windlass doesn’t have to be anything specific either. I have seen everything from trauma shears, to pistol mags. The ideal windlass is a thin, sturdy metal rod, but as long as its between 6-8 inches long, it should do the trick for you.
Be careful not to pick something that has a good chance of breaking on you, like twigs you find on the ground. Give it a few good test bends to make sure it doesn’t break on you when you’re turning it.
If you had the opportunity to get fancy with it, you might throw on the little plastic rings you find under the lid of Gatorade bottles. This helps to retain the windlass and keep it from unwinding on itself. This isn’t a requirement, but it’s an added level of security for something that you're trusting to save your life.
Tie the strap around the windlass about 1/3rd the way down. This will leave you with a long tail and a short tail on either side of the windlass.
Wrap the strap around the affected limb and position the windlass so it’s in easy reach.
Turn the windlass until bleeding stops. Once you are certain you have no more blood coming from the wound, take the short tail and any remaining strap and use it to tie the windlass in place so it doesn’t come unraveled. If you have the Gatorade ring, use that to help secure it as well.
Don’t forget about that tourniquet. Since it’s been improvised, there’s a good chance it can loosen or come undone altogether, especially if the casualty is being carried somewhere.
You need to be vigilant to check the TQ and ensure it’s still controlling the bleeding. I would check a minimum every 5 minutes or so if I had the chance.
If someone arrives on scene with a CAT TQ after you’ve already applied an improvised one, what do you do?
Apply the CAT above the improvised TQ and tighten it down. This way, if the improvised TQ fails, there’s already a CAT in place and ready to go.
NEVER remove a TQ after it’s been applied, let the trauma surgeon do that. If you take it off, there’s a good chance the bleeding will start up again and you might not get it to stop this time.