Where should a tourniquet be placed on a limb to maximize hemorrhage control?

• A. Distal to the wound.
• B. Around the limb near the joint.
• C. On the limb but below the wound.
• D. Proximally, as high as necessary and above the wound but below the body.

Answer: (D)

The main idea is to stop bleeding by cutting off arterial blood flow to the injured area, which requires placing the tourniquet on the limb proximal to the wound—between the wound and the rest of the body. Positioning it as high as necessary ensures you compress the main arteries feeding the area, reliably stopping hemorrhage. It should stay on the limb and be above the wound, not distal to it, so that arterial inflow to the injury is halted. Placing it near a joint or below the wound would not reliably occlude the critical vessels and could allow continued bleeding or cause unnecessary tissue injury. So the best approach is proximally on the limb, high enough to stop arterial inflow and above the wound but still on the limb.