For the inguinal location, once the TCD is appropriately positioned, the belt is buckled and all slack is removed from the belt prior to TCD inflation. Often a click will be heard or felt. Once the TCD is secured in the correct position, the TCD is inflated using a hand pump until the hemorrhage stops and a distal pulse is no longer present. Bleeding should be stopped within 90 seconds. When treating bilateral junctional injuries, a second TCD can be utilized following the same procedure.

For the axillary location, the circumferential belt is secured before attaching the auxiliary strap. The auxiliary strap is not tightened until the TCD is in position, after which it can be pulled tight. Then, as with the inguinal approach, the hand pump is used to inflate the TCD until the bleeding stops and a distal pulse is no longer present.

DOCUMENT time of junctional TQ(s) placement tourniquet itself and on the DD Form 1380 TCCC Card.