With the increased use of tourniquets in tactical medicine, there is an active debate concerning the best location and proper method of storing a tourniquet on an individual’s equipment. While in the end it comes down to individual preference or unit SOP, there are some locations and methods that don’t make sense.
A tourniquet is an immediate lifesaving intervention and it should be treated similarly to a secondary firearm. Chances are your pistol is not carried in its original box packed away so you can claim a capability. It is positioned so the operator has access to it in seconds, under the most extreme circumstances. The same standards for accessibility and immediate operational use should be applied to your tourniquet. The time taken to implement this intervention should be kept to an absolute minimum. Storing a tourniquet in its plastic wrapper can be a fatal mistake. While it increases the service life of the product, it can create a situation in which the tourniquet cannot be accessed by the individual in need. The same situation can be created by storing the tourniquet inside a difficult-to-open, tightly-packed zippered pouch. While storing the tourniquet in a pouch attached to your equipment is advantageous if you are the victim of a large blast since it is far less likely to be torn from your gear, the disadvantages of this location (e.g., not being able to access it quickly) outweigh the advantages.
The best location for a tourniquet in a tactical environment is on the armor, along the midline of the operator’s body, unwrapped and pre-rigged for application. One technique is to secure the tourniquet with multiple rubber bands. The tourniquet can be accessed with either hand, is secured tightly to your individual equipment and is easily removed when needed. Furthermore, storing the tourniquet exposed rather than in a case or pouch provides the oft-needed visual stimulus for a rescuer or casualty to begin the act of tourniquet application. There is a lot to be said for having the answer staring you in the face when you look down or look at a casualty. The stress response to seeing a friend severely injured can often cause a brief period of inaction. Having the tourniquet readily available is one small step to combat this condition.
If your unit SOP is to carry tourniquets wrapped in plastic and stored tucked away inside of a pouch, you should seriously consider reevaluating the standard.