Massive haemorrhage is your first point of attention after assessing scene safety. A tourniquet can be used to control severe extremity haemorrhage. Since a conventional tourniquet is not always at hand, Salchner et al assessed the effectiveness of a space blanket‒improvised tourniquet with a carabiner as a rod.

They concluded that in research setting (healthy volunteers in optimal application circumstances) complete arterial occlusion was achieved in only half of the applications using the improvised tourniquet, while 100% occlusion was achieved every time when the conventional tourniquet was used. Furthermore, the speed of application was inferior in the application of improvised tourniquets (94 seconds vs 27 seconds, P<0.001). The authors advice that improvised tourniquets should be considered only in dire circumstances with uncontrolled extremity hemorrhage and when no commercial tourniquets are available.

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Salchner H, Isser M, Banyai L, Schachner T, Wiedermann FJ, Lederer W. Arterial Occlusion Effectiveness of Space Blanket‒Improvised Tourniquets for the Remote Setting. Wilderness Environ Med. 2023 Apr 24:S1080-6032(23)00043-1. doi: 10.1016/j.wem.2023.02.007. Epub ahead of print. PMID: 37100664.