In wilderness first aid, when is a tourniquet indicated?

• A. For Any Bleeding From an Extremity
• B. For Life-Threatening Extremity Bleeding Not Controlled by Direct Pressure and Hemostatic Dressings; Apply Proximal to Wound, Tighten Until Bleeding Stops, Note the Time, and Do Not Remove Unless Instructed by Medical Personnel
• C. Only After Applying a Splint
• D. Never Use a Tourniquet

Answer: (B)

A tourniquet is used when there is life-threatening bleeding from an arm or leg that cannot be controlled with direct pressure and hemostatic dressings. In that situation, you apply the tourniquet proximal to the wound (between the injury and the heart), tighten it until the bleeding stops, record the time you applied it, and do not remove it unless medical professionals tell you to. This approach is about rapidly stopping heavy arterial bleeding to prevent rapid blood loss when evacuation may be delayed in a wilderness setting.

Why this is the best answer: it matches the purpose and sequence of action for severe extremity hemorrhage—reserve tourniquet use for when direct pressure and dressings fail to control bleeding, and follow the protocol of placing it above the wound, tightening until there is no further bleed, and documenting the time. Other options overgeneralize (bleeding from a limb isn’t always a tourniquet case), require splinting first (tourniquets can be applied as part of emergent care, not only after splinting), or suggest never using a tourniquet, which would leave life-threatening bleeds unchecked.