Which scenario would warrant applying a tourniquet?

• A. Direct pressure fails to control external bleeding
• B. Bleeding is minor and can be watched
• C. Patient requests not to apply
• D. Bleeding from a small scalp laceration

Answer: (A)

When direct pressure fails to control external bleeding, a tourniquet becomes the appropriate next step. The goal is to rapidly reduce blood loss from a life-threatening limb bleed when simpler methods can't stop it. A tourniquet works by constricting flow to the injured area, buying crucial time to get the patient to definitive care.

Why this scenario fits best: it describes a situation where bleeding is not controlled by direct pressure, and the injury is on a limb where a tourniquet can safely be applied to save life. Other scenarios don’t indicate uncontrolled, life-threatening limb bleeding: minor bleeding managed with watchful waiting doesn’t require a tourniquet; a request not to apply it isn’t a justification in a hemorrhage emergency; and a small scalp laceration is usually handled with direct pressure rather than a tourniquet (the scalp is not typically treated with a tourniquet and bleeding is addressed by local pressure and wound care).

In short, tourniquets are reserved for severe, uncontrolled limb bleeding when direct pressure cannot stop the hemorrhage.