Issues related to the use of tourniquets on the battlefield

On the battlefield, a properly applied tourniquet can be an extremely effective means of controlling severe extremity wound hemorrhage. However, a great deal of confusion exists among soldiers, medics, and military medical officers on a number of tourniquet-related issues. What is an appropriate combat tourniquet? When is it appropriate to use a tourniquet? When and by whom should a tourniquet be removed? Under what conditions should a tourniquet not be released or removed? What are the most effective ways to increase limb salvage while using a tourniquet? These and other issues were addressed by a panel of experts at the 2003 Advanced Technology Applications for Combat Casualty Care Conference, August 21 and 23, 2003, St. Pete Beach, Florida. Here we review those issues and present a summary of the panel's recommendations.