When should a tourniquet be considered in EMS trauma care?

• A. Immediately for any bleeding
• B. For life-threatening, uncontrolled extremity bleeding after direct pressure and hemostatic measures have failed or are unavailable
• C. Never use tourniquet
• D. Only after hospital arrival and evaluation

Answer: (B)

Tourniquet use is reserved for life-threatening, uncontrolled extremity bleeding when direct pressure and hemostatic measures have failed or are unavailable. In EMS, you first apply direct pressure and, if available, hemostatic dressings. If bleeding remains severe and uncontrollable, a tourniquet should be applied promptly, proximal to the wound, to rapidly control hemorrhage and keep the patient alive while transport is arranged. It is not for every bleed, it is not something that’s only done after hospital arrival, and it is not never used—these guidelines help balance rapid hemorrhage control with limiting potential limb damage.