In TFC, there is more time to expose the wound and determine the actual site of bleeding. TQs should be applied more deliberately in the TFC setting 2 to 3 inches above the wound and directly on the skin to maximize effectiveness and minimize the amount of healthy tissue that might be impacted by a TQ placed too high on the limb. Do not put tourniquets over the knee, elbow, a holster, or other equipment, or a cargo pocket containing bulky items, as these locations and materials prevent adequate vascular compression.

If bleeding is not controlled and the distal pulse absent after the first TQ has been placed in TFC, it may be necessary to apply a second TQ side-by-side and proximal on the limb to the first.

All traumatic amputations warrant tourniquet placement, as bleeding may restart, even if it appears to have stopped due to the initial injury or perhaps the lack of circulating blood volume.

Ideally, bleeding should be stopped within one minute of recognition that life-threatening hemorrhage is present.

The time of tourniquet placement should be documented on the tourniquet itself and on the DD Form 1380 TCCC Card in TFC.