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This post originally went up on the blog in October, 2025. I’ve updated it slightly, and recorded audio to accompany it. This should have gone up back then...apologies.
The tourniquet has done a complete 180 in my lifetime. When I was a kid, every reputable source of information recommended the tourniquet only as a last resort, after all else had failed. When I started deploying to the GWOT, tourniquets were coming on strong in military circles. I would be another decade before civilian EMS embraced tourniquets. Now tourniquets are the darling of the “tactical community” and emergency medicine seems to begin and end with them. Unfortunately, tourniquets suck as a general-purpose medical intervention!
Warning: Graphic Medical Photo Below!
I’m constantly curious about the widespread adoption of tourniquets in the “concealed carry lifestyle” and EDC spaces, to the exclusion of all other medical gear. While they are great at what they do, tourniquets ONLY DO ONE THING! I don’t think a tourniquet should be the first thing you think of when you think of trauma medicine. Why?
Because tourniquets suck at treating most injuries!
While I think carrying a tourniquet is a good idea, I also think carrying ONLY a tourniquet is a terrible idea. Tourniquets have gotten this reputation is the all-star medical tool but this reputation is undeserved. Let’s delve a bit deeper into why I don’t carry a tourniquet in my day-to-day, personal life, and why I think tourniquets suck as an EDC medical item.
I have written about my complaints with the tourniquet before. The tourniquet stops hemorrhage from extremities quickly, easily, and effectively. So why am I unhappy with the tourniquet? I’m glad you asked. While it does one job exceptionally well, it leaves literally every other base uncovered.
Real quick, let’s quickly cover the indications for a tourniquet:
massive (generally arterial) bleeding from an extremity that is unlikely to be controlled by other means,
amputations above the wrist or ankle, or
multiple injuries on the extremity that exceed your ability to treat individually.
The only time deviation from this is acceptable is when the tactical situation makes direct pressure impossible...
And this is where we’ve gotten tourniquets wrong. The TCCC/TECC curriculum is wonderful at what it does: teaching the use of hemostatic agents, wound packing, pressure dressings, and yes, tourniquets, in a HOSTILE environment. Tourniquet application to “any bleeding” is ONLY applicable in Care Under Fire/Direct Threat Care medicine. Once the threat has been eliminated (or even a temporary lull has been created, reducing the care phase to Tactical Field Care/Indirect Threat Care), other interventions should be considered instead of a TQ.
The TCCC/TECC doctrine is sound, but only in context. It was/is not intended for general first aid. Slapping tourniquets “high and tight” is applicable to the battlefield (foreign or domestic), but outside of those narrow confines is usually not what is in the patient’s best interest. Let’s be real: you are many times more likely to need a tourniquet for any other cause than as a result of hostile action.
Now, let’s talk about why tourniquets suck and I don’t carry one.
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