While completing the TTA, any interventions performed in Care Under Fire should be reassessed.

Previously applied tourniquets should be assessed for effectiveness (bleeding has been stopped and distal pulses are absent).  

If the tourniquet is not effective, tighten the tourniquet and/or apply a second tourniquet side-by-side and proximal to the first one.

Assess for unrecognized hemorrhage and control all sources of bleeding. If not already done, use a CoTCCC-recommended limb tourniquet to control life-threatening external hemorrhage that is anatomically amenable to tourniquet use or for any traumatic amputation. Apply directly to the skin 2-3 inches above the bleeding site. If bleeding is not controlled with the first tourniquet, apply a second tourniquet side-by-side with the first.