Tell me you don’t know how to use your tourniquet without telling me you don’t know how to use your tourniquet

It is said that command presence begins with how we look in our uniform. It’s psychology at the most basic level. How we present ourselves physically can often dictate how interactions go with members of the public. We don’t even have to open our mouths; we don’t have to take a single action beyond arriving. People will make decisions about who we are and what we’re capable of within seconds of meeting us. Exactly how much influence our presence has on outcomes is unknown, but it is a contributing factor.

This principle of professional appearance is one of the reasons why there is a fascination (especially in academies) on shining shoes, ironing shirts, shaving faces and grooming hair. We are often told not to judge a book by its cover, but I guarantee I can assess how familiar an officer is with their tourniquet just by looking at how it is staged.

The Combat Application Tourniquet (commonly referred to as C-A-T) is the most popular choice among U.S. law enforcement. Regardless of your brand preference, a quality tourniquet is an essential tool, every officer should carry at least one. More is better. A tourniquet has three main components: a strap, a windlass and a means to secure that windlass.

How an officer stages their tourniquet determines how efficiently they can use those three elements. If you need a tourniquet, it means you’re dealing with a catastrophic bleed. Although it is said all bleeding stops eventually, we would much rather it stopped on our terms. Time is of the essence. Slow and steady won’t win this race. Proficiency in access and application of excruciating amounts of pressure is the priority.

Step one: Take it out of the packaging

Some of you are going to think I’m kidding. I promise you I’m not. From new recruits to veteran officers, I’ve seen many walking around with tourniquets still in their shrink-wrapped packaging. Carrying a packaged tourniquet is like carrying an unloaded pistol with some loose ammunition in your pocket. Sure, you have the equipment with you; but your speed of deployment will not match the speed required to prevail.

I can forgive a recruit for not knowing any better. You don’t know what you don’t know. Once they begin training and using the tool regularly — building it into scenarios and range training — they will understand the importance of accessing it fast. As for the seasoned senior officers, I have no idea what they’re thinking. One officer told me he kept it in the packaging to keep it clean. I cannot predict what every tourniquet application will look like, and the circumstances under which it will take place; but I promise you the tourniquet is not sterile. It’s going to be covered in sweat, it’s going to be covered in blood. It will likely be covered in other contaminants too. A tourniquet does not belong wrapped in a cellophane package. When you carry one, it needs to be primed and ready for work. which leads us to our next point.

The windlass retention strap tells a story

The windlass retention strap is the gray-colored part with the word “time” printed on it. The staging of the strap tells me if you train. The people who keep it neatly across the windlass (example on the right in the picture above) are concerned with their appearance, they do not train. They want you to know that they’re very neat and organized. Everything’s under control and strapped down. They are ready to run, jump and fight — they are also ready to bleed to death. The windlass should never be strapped into the clip when the tourniquet is in a holder (example on the left in the picture above). The windlass should only be strapped into the clip after the tourniquet has been applied. Having the windlass secured in the clip prior to use slows down application by adding an unnecessary step. Try accessing the windlass with one hand, in the dark, with your hands covered in blood.

If you want to die, keep the tab across the windlass clip while the tourniquet is in storage. If you want to win the race to get the tourniquet applied, the windlass clip should be open.

Photo/Leon Reha

Staging of the tourniquet

There are several different ways to fold and stage the tourniquet. I’ve tried a few different options over the years, and I have my personal favorite. Some of the variants involve how much of the tourniquet tab is folded over to create a handle or a gripping surface. Another variant is how big the initial loop you create is. Some people will tell you the loop created in your tourniquet should be as large as possible. Others will tell you to make the loop smaller, roughly the size of your arm. The idea being that if you are trying to do a single-hand application to your own arm, one quick pull will apply lifesaving pressure.

How large you set the opening on your tourniquet is completely up to you. So long as you know how you staged, it and why you staged it that way. The non-negotiable elements are:

1. You must be able to pull the tourniquet out with one hand.
2. It must fall freely open to present a loop.

The point of the freely available loop is that you will be trying to immediately slide it over a bleeding limb. That limb might be yours! You should not need to engage in a two-handed wrestling match to unravel it like a bundle of Christmas tree lights you’ve just pulled out of a box in the garage. If the tourniquet needs two hands to apply it, you’ve staged it wrong.

Top 10 tourniquet training tips

Your tourniquet is more than just another piece of equipment — it’s a lifesaving tool that demands proper preparation and practice. How you stage it reveals your level of training, understanding, and readiness for critical situations. The extra seconds you save through proper staging could mean the difference between life and death — yours or someone else’s.

Regular training under realistic conditions is essential to building the skills needed for rapid deployment. Your preparation will speak louder than words in the moments that matter most. To help you become proficient with this critical tool, consider the following training tips:

1. Stage it where you can access it with either hand.
2. Have one for practice. Your operational tourniquet(s) should be for one-time use only. Have a tourniquet designated for training only that is the same make and model as your “real” one. They are available in different colors to help keep things organized. If you wear out or break your training tourniquet, so what, get another. Be proud you’re training that hard!
3. Time your application. You should be able to access it with either hand, and apply it to any one of your limbs in less than 30 seconds. Faster is better.
4. Train in the dark (or close your eyes at least).
5. Train with nitrile/latex gloves on.
6. Train with wet hands/gloves
7. Train standing, seated, prone.
8. Train in your car restricted by the steering wheel, laptop and seatbelt.
9. Train for double applications for leg injuries (tourniquets side by side).
10. Train to apply it on a trapped limb, where you can’t slide the loop over the end.

NEXT: Gordon Graham on why tourniquet training is critical in law enforcement: