This column appeared in the Colorado Springs Gazette. To syndicate the national version, contact DrHubbard [at] TheSurvivalDoctor [dot] com.

by James Hubbard, MD, MPH

The tragic events in Boston delivered a stark reminder that someone can set off a bomb just about any time, any place. But as devastating as any attack is, you can usually learn something from it that may save a life in the future.

The two bombs in Boston caused many horrible injuries to the victims’ legs, resulting in multiple amputations. The legs contain major arteries which if injured can cause blood loss so quickly you can die within minutes.

Why were there so few deaths when the risk for life-threatening blood loss was so great? I think it was because so many medical personnel who knew how to apply tourniquets were at the race or were there within minutes. I just read of a young woman whose doctor told her that if not for a fireman who applied a makeshift tourniquet from part of a shirt, she would have surely died.

In Colorado Springs, we’re lucky to have many military and medical personnel who have first responder skills. But what if they’re not around when an arterial injury occurs—and you are?

When to Use a Tourniquet

Recently, I was talking to a group about how to stop blood loss in the rare instance that direct pressure to the wound won’t (and in Boston, I’m sure they were loaded with these “rare instances”). When I mentioned a tourniquet, someone asked, “What is that?”

At that point I learned a valuable lesson too because I thought everyone knew what a tourniquet was—maybe just not how to use one.

Well, everyone should know what a tourniquet is, when to use it, and how to use it because it’s so simple. So I’ll teach you the basics here. One day, you may be able to save your life or someone else’s.

But, here’s another thing you should know about tourniquets: You only want to use one if the bleeding is life-threatening and direct pressure is not doing the job. Since a tourniquet cuts off all the blood supply, you run a risk of killing the tissue downstream from it. In other words, to save your life, you may lose a limb.

In the Boston bombings, I suspect many of the damaged limbs were beyond saving, but as a general rule, the longer you keep the tourniquet on, the more the person is likely to lose that extremity.

How to Use a Tourniquet

A tourniquet is composed of a thick strip of strong material. You can buy one or make it out of a belt; rope; or a strip of cloth torn from, say, a shirt. The strip should be a half-inch to a couple of inches wide, and long enough to encircle an arm or leg.

Wrap the tourniquet around an area of the injured limb that’s closer to the heart than the injury. For instance, if the wound is at knee level, wrap it around the thigh. If the wound is close to the wrist, wrap it closer to the elbow, or even the upper arm.

Tighten until the bleeding stops, and fix it in place. If you’re using a belt, wrap a second time and stick the buckle prong in the hole, just like normally. With a cloth, tie both ends to a stick or something similar, and tighten by twisting the stick around and around. I show you how in a video on my website. Better yet, ask someone who already knows. It just takes a few minutes to learn. I bet they’ll be glad to teach you. Who knows? The life you save one day could be your teacher’s.

Colorado Springs family doctor James Hubbard teaches how to survive when you can’t get to a doctor at, one of the most popular survival websites. Dr. Hubbard is the author of the best-selling e-books
The Survival Doctor’s Guide to Wounds and The Survival Doctor’s Guide to Burns.