For severe bleeding, first press firmly on the wound with your hand; if bleeding from a limb can’t be stopped, apply a tourniquet and call 120 right away.
The proper order is to press hard on the wound with your hand or a cloth; if bleeding from an arm or leg won’t stop, put on a tourniquet and then call 120. Once applied, never loosen it. Battlefield data shows that 90% of patients whose tourniquets were applied before going into shock survived, compared with only 10% whose tourniquets were applied after shock set in; all 5 patients who needed a tourniquet but didn’t get one died. Wrap the tourniquet above the bleeding site, twist until the flow stops, and write down the time. Do not use shoelaces or rope as substitutes. For neck or torso injuries, only compression works — never apply a tourniquet there.
A twist‑type tourniquet costs anywhere from a few dozen to…
Over six years, 11 Level I trauma centers in Texas treated 1,026 patients with vascular injuries to the limbs;
A twist‑type tourniquet costs anywhere from a few dozen to over a hundred yuan; keep one in your car or first‑aid kit. Learning how to wrap it above the wound, twist until bleeding stops, and note the time takes just a few minutes.
Over six years, 11 Level I trauma centers in Texas treated 1,026 patients with vascular injuries to the limbs; 181 of them (17.6%) had a tourniquet applied before arrival. Unadjusted mortality rates were 3.9% for those with a tourniquet versus 5.2% for those without. After adjusting for other factors, tourniquet use remained strongly linked to survival, with an odds ratio of 5.86 (95% CI 1.41–24.47). At a Baghdad field hospital, 90% of 232 injured patients whose tourniquets were applied before shock survived, while only 10% survived after shock; all 5 patients who required a tourniquet but did not receive one died, and 87% of those who did get one lived. The recommended sequence is: direct manual pressure using any cloth or towel → if bleeding from a limb persists, apply a tourniquet → call 120 → never loosen the tourniquet.
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
Open source linkDo 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.