When should a tourniquet not be loosened after application?

A tourniquet should not be loosened after application when the surgical facility is more than 2 hours away. This is crucial because loosening a tourniquet can cause a significant risk of renewed bleeding, which may lead to serious complications or even death if emergency surgical care is not immediately available.

Tourniquets are primarily used to control life-threatening bleeding from limb injuries, especially when other methods such as direct pressure are ineffective. If a casualty is stable, it implies that their condition is monitored and managed appropriately, potentially allowing for a controlled situation where it might be safe to reassess the need for a tourniquet.

In cases where the tourniquet has been in place for under 6 hours, it's generally accepted that it can be inspected and potentially loosened under controlled medical supervision. However, this needs to occur in a setting where definitive care is nearby. Lastly, the presence of amputations does not specifically dictate that a tourniquet should not be loosened, but rather calls for careful evaluation of the overall situation and the need for ongoing hemorrhage control.

Thus, if evacuation or transport to a surgical facility is delayed or exceeds 2 hours, maintaining the tourniquet without loosening it is a critical decision to prevent