Instructor Preparation - Online Blended Part 1

156 videos, 8 hours and 35 minutes

Course Content

When Tourniquets Don't Work - Applying a Second

Video 69 of 156
1 min 48 sec
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Exploring Further Steps When Tourniquet Fails: What's the Next Move?

Evaluating Tourniquet Effectiveness

Assessing the tourniquet's efficacy involves checking for cessation of bleeding and the presence of a distal pulse.

Potential Issues

If bleeding persists and a distal pulse is still present, further action is required.

Ensuring Tightness

Firstly, verify that the tourniquet is sufficiently tight; additional pressure may be necessary for effectiveness.

Application Force

Remember, significant force is required during tourniquet application to achieve hemostasis.

Exploring Alternatives

If the initial tourniquet is correctly applied but ineffective, alternative measures must be considered.

Available Options

Choices include applying direct pressure, using a haemostatic dressing, or applying an additional tourniquet.

Direct Pressure and Dressing

Initially, consider employing direct pressure and a pressure dressing, especially if prior attempts were unsuccessful.

Effectiveness Enhancement

With the tourniquet in place, reduced blood pressure may improve the efficacy of direct pressure and dressing.

Haemostatic Dressing or Additional Tourniquet

Alternatively, the use of a haemostatic dressing or applying another tourniquet presents viable options.


Due to limited guidance, the choice between haemostatic dressing and additional tourniquet relies on the caregiver's judgment.

Improvised Tourniquet

In the absence of commercial options, improvising a tourniquet may be necessary, prioritizing patient safety.

Applying Additional Tourniquets

If multiple tourniquets are required, apply them above or below the initial one, maintaining a 5cm distance from joints.

Location Considerations

Consider applying additional tourniquets to the lower limbs, where reduced blood pressure may enhance effectiveness.

Time Documentation

Record the time of each tourniquet application and refrain from removing any tourniquet.

Rare Circumstances

In extreme cases, a third tourniquet may be necessary, although uncommon.

Learning Outcomes:
  • IPOSi Unit three LO3.1, 3.2, 3.3 & 3.4