Every effort should be made to convert tourniquets in less than 2 hours if bleeding can be controlled by other means unless the casualty is in shock, you cannot closely monitor the wound for re-bleeding, or there has been an amputation; however, do not attempt tourniquet conversion if the tourniquet has been on for six or more hours. Also, consider leaving the tourniquet in place if the tactical or medical considerations make transition to other hemorrhage control methods inadvisable.

While the original tourniquet is still in place controlling the bleeding, pack the wound with hemostatic gauze, if available, and hold pressure for three minutes. Then, apply a pressure bandage over the dressing, maintaining pressure. Afterward, slowly release the tourniquet (over at least one minute) while closely observing for bleeding. If the wound packing and pressure bandage do not control the bleeding, retighten the tourniquet or follow the steps to replace the tourniquet if it is above the clothing, like a high and tight tourniquet. In cases where the conversion has failed, it is appropriate to try again within the next two hours, as long as it hasn’t been more than six hours since the original tourniquet was applied.

If the conversion is successful, loosen the tourniquet and move it down to just above the pressure dressing, loose but with no slack in the strap in case it is needed later, and annotate the time of tourniquet removal on the DD Form 1380, TCCC Casualty Card. Periodically reassess the wound for recurrent bleeding and reassess after any casualty movements.