TABLE 2.

Tourniquet Conversion or Replacement Recommendations

Indications for TQ Replacement	Indications for TQ Conversion	Indication to Leave a TQ in Place
Tourniquet adjustment from “high & tight”: when a “high & tight” tourniquet previously applied in a high threat situation can be better assessed for proximity to bleeding site.	Availability of alternative methods: when other methods of bleeding control, such as direct pressure, hemostatic agents, or wound closure become feasible and are readily available.	A tourniquet is controlling bleeding for an obvious amputation or a failed conversion attempt
Tourniquet adjustment required: if the initial application of the tourniquet was not effective in controlling bleeding, adjusting the placement or tension of the tourniquet may be necessary. In such cases, replacing the tourniquet allows for a more secure and appropriate application.	Wound is amenable to a hemostatic or pressure dressing and three criteria for conversion are met: 1. Casualty is not in shock. 2. Possible to monitor wound for rebleeding. 3. TQ is not being used to control bleeding from amputation.	Tourniquet has been in place for more than 6 h.
Every effort should be made to replace TQs more distally in less than 2 h	Every effort should be made to convert TQs in less than 2 h if bleeding can be controlled by other means.