My cousin, an undercover police officer, has had one and exactly one occasion to use a tourniquet. But it was a freakish circumstance. A car bomb had completely severed both of the patient's legs and almost completely severed one arm while throwing him clear of the wreck. My cousin used his own belt to tie off one leg, used a bystander's belt to tie off another leg, and used direct pressure to stop the arm bleeding.
He didn't use the bystanders to apply pressure to the femoral arteries because none of the few people who were around were willing to approach the patient that closely. Some of them were too busy freaking out, but the it turns out the rest knew something my cousin didn't: the victim was the brother of a mob boss. Hence the car bomb.
(And when the mob boss sent a $5,000 thank-you check to my cousin, boy, wasn't THAT awkward for him, for the department, and come to think of it probably for the mob family.)
So yeah, as far as I know, the only remaining reason to use a tourniquet is if the limb is doomed anyway and you don't have enough hands available to apply pressure to all the spots on all the people who are bleeding.
(Caveat: I am SO not an expert. I am, however, as someone with a neurological disorder that usually prevents me from outwardly expressing recognizable emotional expression, always apparently calm during emergencies. So I've studied up a bit, since people keep PUTTING me in charge during emergencies.)
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