Where should a tourniquet be applied to control bleeding from an amputation?

Where should a tourniquet be applied to control bleeding from an amputation?

• A. On the remaining limb
• B. Direct pressure first, then above the amputation
• C. Above the level of the amputation
• D. Below the amputation

Answer: (C)

The main idea is that a tourniquet stops life-threatening bleeding by cutting off arterial inflow, so you need to compress the vessels proximal to the injury. For an amputation, the best spot to do this is above the level of the amputation—on the part of the limb that remains intact and proximal to where the tissue was severed. Placing the tourniquet above the injury ensures it occludes the major arteries feeding the amputated area, effectively stopping the bleeding. Why not elsewhere? Placing a tourniquet on the remaining limb distal to the injury wouldn’t reliably control the bleeding because the vessels feeding the wound are closer to the amputation site. Placing it below the level of the amputation would also fail to stop arterial inflow to the damaged area. In practice, you try direct pressure first; if bleeding persists, apply the tourniquet proximal to the amputation. Time the application and monitor the patient accordingly.

The main idea is that a tourniquet stops life-threatening bleeding by cutting off arterial inflow, so you need to compress the vessels proximal to the injury. For an amputation, the best spot to do this is above the level of the amputation—on the part of the limb that remains intact and proximal to where the tissue was severed. Placing the tourniquet above the injury ensures it occludes the major arteries feeding the amputated area, effectively stopping the bleeding.

Why not elsewhere? Placing a tourniquet on the remaining limb distal to the injury wouldn’t reliably control the bleeding because the vessels feeding the wound are closer to the amputation site. Placing it below the level of the amputation would also fail to stop arterial inflow to the damaged area. In practice, you try direct pressure first; if bleeding persists, apply the tourniquet proximal to the amputation. Time the application and monitor the patient accordingly.