Hemorrhage Control / Tourniquet Use — Utah 2025 Protocol
Uncontrolled hemorrhage is the #1 preventable cause of trauma death. Stop the bleed first.
Steps by Cert Level
ALL: Direct pressure first for most wounds. Tourniquet for life-threatening extremity hemorrhage — apply 2–3 inches above wound. Tighten until bleeding stops and note time. Commercial TQ preferred (CAT, SOFTT-W).
EMT: Wound packing for junctional hemorrhage (groin, axilla, neck — areas TQ can't reach). Pack firmly with gauze. Pressure dressing over pack.
AEMT: Hemostatic gauze (QuikClot, Combat Gauze) for junctional wounds — pack tightly, hold pressure 3 min. IV access en route.
PARAMEDIC: TXA (Tranexamic Acid) 1g IV over 10 min within 3 hours of injury for hemorrhagic shock. Blood products per protocol (pRBC/FFP). Permissive hypotension (SBP 80–90) for penetrating trauma until surgical control.