The primary plan is always a commercially available tourniquet. However, if no commercially available tourniquet is available, a successful tourniquet can be made using the casualty’s own clothing: cut up the pants line including the seams, wrap the fabric around the limb, tie a square knot, and tighten with a windlass.
*Ideally, the windlass should be secured with another strip of fabric. This video demonstrates an easy way to hold the windlass in place without an additional tie, but it could come loose during casualty movement.
Sometimes, proper medical supplies are not readily available. Dr. Shertz’s pant leg “everything went to shit” tourniquet is demonstrated on a 9-year old girl, and confirmed with a doppler ultrasound, the blood to the limb is occluded. Most importantly, the 9-year old tightens the tourniquet herself to a level sufficient to stop blood flow, without any complaining, crying, whining, or tapping out.
