There is a lot of discussion on whether to place a tourniquet (TQ) "high and tight" on an arm or leg, or place 2-3 inches above the wound, even if on the forearm or lower leg, sometimes called a "double bone compartment. " There is also those who say a tourniquet can be on for 1 hour, or for 8+, so which is it?
The short answer is, it depends on the wound, who you are, and where you are.
"When do we do high-and-tight? "
High-and-tight is a "catch all" for most situations and non-medical professionals. It's easy to remember and unlikely to be placed distal (away from the injury, not between injury and heart) or be placed over a joint which would make it ineffective. High and tight also accounts for blast wounds where the wound may be more extensive or deeper than it appears, and when placing over clothes during "Care Under Fire" where the wound and location of bleeding may not be easily apparent.
For non-medics and Tactical Combat Casualty Care (TCCC) trained individuals, high-and-tight is for care-under-fire.
For those close to a hospital, within 1-2 hours, high-and-tight is also fine. We will discuss why if farther away from care you may want to consider other options.