For severe bleeding, first press firmly on the wound with your hand; if this fails on limbs, apply a tourniquet and call 120 immediately

A twist-style tourniquet costs anywhere from a few dozen to over a hundred yuan; it can easily be stored in a car or first-aid kit. Learning how to position it above the wound, twist it until bleeding stops, and note the time takes just a few minutes.

11 Level 1 trauma centers in Texas, USA, received 1,026 cases of limb vascular injuries over 6 years. Among them, 181 cases (17.6%) had tourniquets applied before arriving at the hospital. Calculating directly without any adjustments, the mortality rate for those with tourniquets was 3.9%, and 5.2% for those without. After leveling other conditions (multivariate adjustment), applying a tourniquet remained independently associated with survival. Adjusted OR 5.86, with a 95% CI of 1.41 to 24.47. Among 232 casualties at a Baghdad field hospital: 90% of those who applied a tourniquet before the onset of shock survived, while only 10% of those who applied it after shock survived. All 5 people who required a tourniquet but did not receive one died, while those who received it had an 87% survival rate. The 2025 International Red Cross guidelines require calling emergency services for all severe bleeding. First have the injured person press the wound, call for help, then the rescuer applies pressure. Consider a tourniquet only for limb bleeding not controlled by pressure. Once applied, leave it in place for emergency personnel. Sequence: direct pressure with clothing or towels while someone calls 120 → tourniquet for uncontrolled limb bleeding → do not loosen.

Teixeira PGR 等 (2018). Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. Journal of the American College of Surgeons. https://doi.org/10.1016/j.jamcollsurg.2018.01.047 ; Kragh JF 等 (2009). Survival with emergency tourniquet use to stop bleeding in major limb trauma. Annals of Surgery. https://doi.org/10.1097/SLA.0b013e31818842ba ; 中国医师协会急诊医师分会等 (2020). 止血带的急诊应用专家共识. 中华急诊医学杂志 29(6):773-779：「院前急救时，止血带一旦使用则不建议松开，除非得到可以替代的彻底止血的救治」「最长使用时间不应超过2 h。但如果客观情况无法到医院救治或者无替代止血办法，则在得到正规救援前不解除止血带」. https://doi.org/10.3760/cma.j.issn.1671-0282.2020.06.006，全文 http://www.cem.org.cn/rhtml/20200606/index.htm；International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025，第 255–256 页：「Emergency medical services (EMS) should be accessed for all severe bleeding」「Once a tourniquet has been applied, keep it in place until EMS arrive」，步骤为「1. Ask the person to apply direct pressure to their injury with their hands」「3. Access EMS」「4. Apply direct pressure to the bleed」「5. If direct pressure is ineffective and the person is bleeding from an arm or leg, consider applying a tourniquet」. https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf

Do not use thin items like ropes or shoelaces as tourniquets; they cannot compress the arteries and may cut the skin. Once a tourniquet is applied, do not loosen it periodically to "release blood." Bleeding on the neck and torso should only be compressed, not tourniqueted. In that battlefield data, the tourniquets themselves did not cause anyone to undergo amputation; there were 4 cases of transient nerve paralysis. The expert consensus among Chinese emergency physicians is consistent: once applied pre-hospital, it is not recommended to loosen it unless there is another way to achieve complete hemostasis. For upper arm bleeding, apply the tourniquet to the upper middle third of the arm; for thigh bleeding, apply it to the upper thigh. Do not apply tourniquets to the forearm, lower leg, elbow, or knee. The consensus suggests that the total time from application to hospital arrival should ideally not exceed 2 hours, but if a hospital cannot be reached and there is no other way to stop the bleeding, do not undo it until professional rescue arrives. Improvised tourniquets made from belts, neckties, or sleeves are difficult to use effectively on their own; they must be paired with a stick to twist them tight.