REBEL Core Cast 144.0: Tourniquet Tips

Nov 3, 2025

Tourniquets are essential for saving lives and limbs, especially during arterial bleeding. Proper placement is crucial—aim for 5-6 cm above the bleed and avoid the joints. The windlass technique offers minimal extra pressure; tighten the Velcro first, then twist the windlass carefully. Timing is critical—note when you apply a tourniquet to help with future treatment decisions. Immediate application can make a significant difference, alleviating past concerns about limb loss with timely, correct use.

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ADVICE

Optimal Tourniquet Placement

Place a tourniquet 2–3 inches (5–6 cm) above a known arterial bleed and avoid joints that block compression.
If the source is unknown, put the tourniquet as high on the limb as possible and adjust later if needed.

ADVICE

Tighten Velcro First, Windlass Last

Tighten the Velcro strap down first and then twist the windlass only one to two turns to finish compression.
Stop tightening once arterial bleeding stops; avoid sloppy application or excessive windlass turns.

ADVICE

Record Application Time

Note the exact time the tourniquet was applied to track ischemia time distal to the device.
Use that time to guide when to permit reperfusion to reduce the risk of limb loss.

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📌 Key Points

🩸 Tourniquets save lives and limbs: Apply immediately when you’ve got arterial bleeding.
📍 Placement matters: Position the tourniquet 5–6 cm proximal to the arterial bleed, or if you can’t identify the exact source, place it as high up on the limb as possible.
🔧 Windlass technique: The windlass provides only a small amount of extra pressure. Tighten the velcro first, then twist the windlass 1–2 turns to complete compression.

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⏰ Highlights

00:00 Introduction to Tourniquets
00:40 Optimal Placement of Tourniquets
01:21 Proper Tightening Techniques
01:57 Importance of Timing and Application
02:36 Summary and Conclusion

📝 Introduction

In this episode of the Rebel Core Content podcast, Swami provides crucial tips on using tourniquets. Highlighting the significance of these life and limb-saving devices, the discussion focuses on the optimal placement of tourniquets, emphasizing placing them 2-3 inches (5-6 cm) above the bleeding source and avoiding joints. Swami also advises on the correct way to tighten the tourniquet using the Velcro strap first, followed by minimal use of the windless. The importance of noting the application time to avoid prolonged arterial flow interruption is also discussed. The episode concludes with a reminder to visit the podcast’s website for more valuable content.

Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO)