Tactical Field Care also allows the responder time to check tourniquet effectiveness and to document the time of placement.

The effectiveness of a tourniquet can be assessed by ensuring that bleeding has stopped and by checking for a pulse distally on the limb from where the tourniquet has been applied.16 If bleeding continues or you detect a pulse, tighten the existing tourniquet or apply a second tourniquet next to the first, more proximally on the limb.

The time of tourniquet placement should be documented on the tourniquet itself and on the DD 1380 in TFC (and not during Care Under Fire/Threat).

Ineffective tourniquet use remains common, and in one process improvement project published in 2012, 83% of limbs treated with a tourniquet had palpable distal pulses and 74% did not have a major vascular injury; concurrently, no major vascular injury presented without a tourniquet. (King 2012-3)

During the early part of World War II, medical personnel briefly loosened tourniquets every 30 minutes, to allow reperfusion via intact collateral circulation. As a result, death sometimes occurred from the cumulative effects of the bleeding. Wolff and Adkins found that an unacceptable number of soldiers died as a result of incremental exsanguinations from repeated loosening of the tourniquet, and the practice justifiably was abandoned.