New York State Emergency Medical Technician (EMT) Practice Exam

When using a stick and square knot as a tourniquet for severe bleeding, when should the EMT stop twisting the stick?

1. Cover the tourniquet with a sterile dressing

2. When the bleeding stops

3. Until the radial pulse disappears

4. After 10 minutes of application

The correct answer is: When the bleeding stops

When using a stick and square knot as a tourniquet for severe bleeding, it is essential to stop twisting the stick when the bleeding stops. This indicates that the tourniquet has effectively occluded the blood vessels, and further twisting could lead to unnecessary tissue damage or complications. The primary goal of using a tourniquet is to control life-threatening hemorrhage, and once hemostasis is achieved, the tourniquet should be secured in place without additional manipulation. In practical application, continuing to twist the stick after the bleeding has ceased can cause excessive pressure on the surrounding tissues, potentially leading to nerve injury, loss of limb, or other complications. Therefore, recognizing the moment when the bleeding is controlled is crucial for both the patient's safety and the effectiveness of the intervention. While other options may seem plausible at first glance—such as monitoring for pulse disappearance or applying sterile dressings—these actions are secondary to the primary goal of stopping hemorrhage. It is solely the cessation of bleeding that dictates when to cease further tightening of the tourniquet.