How to stop severe bleeding with a tourniquet
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Severe limb bleeding can kill in minutes. A tourniquet placed early and tight enough stops it.
What you need
- Commercial tourniquet
- Gloves
- Marker for the time
Step by step
Protect yourself
Gloves on, scene safe. [1]
Recognize the bleeding
Blood spurting, pooling on the ground or soaking through dressings is life-threatening. [1]
Apply pressure first
Press hard on the wound with your hand or a dressing while you get the tourniquet. [1]
Place the tourniquet
About 2 to 3 inches above the wound, not over a joint. If you cannot see the wound, place it high on the limb. [1]
Tighten
Pull the strap tight, then turn the windlass until the bleeding stops and the pulse below is gone. Lock the windlass. [1]
Record the time
Write the time it was applied on the tourniquet or the patient. Do not loosen it. [1]
Treat for shock
Lay the patient down, give oxygen, keep them warm and transport quickly. Add a second tourniquet above the first if bleeding continues. [1]
Common errors
- Not tight enough (bleeding gets worse).
- Placing it over a joint.
- Loosening it to check the wound.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Active shooter casualty
- Newborn respiratory distress
- Neuroleptic malignant syndrome
- Agitated patient with excited delirium
- Pain management, hip fracture
- Traumatic cardiac arrest
31 Making Synapses cases train this skill: open the case library
Sources
Facts and steps follow NREMT psychomotor skill sheets (EMT and Paramedic). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.