What should be done if a tourniquet is ineffective?

Applying a second tourniquet directly above the first is the most effective response if the initial tourniquet proves ineffective. This method provides additional compression to the affected area, enhancing the chances of achieving hemostasis. When the first tourniquet does not control severe bleeding, adding another one can help overcome any limitations in the first, such as insufficient pressure or misplacement.

In traumatic scenarios, multiple applications of tourniquets can be necessary to control arterial bleeding. The placement of the second tourniquet above the original location ensures that it is positioned correctly, targeting the bleeding source and increasing the likelihood of stopping or significantly reducing blood loss.

While other options might seem appealing—like moving the tourniquet higher, removing it, or switching to hemostatic agents—they may not provide immediate control of severe hemorrhage. Moving the existing tourniquet may inadvertently cause further complications if it was applied correctly. Removing it could allow the bleeding to resume, worsening the patient's condition. Using hemostatic agents has its place in hemorrhage management, but they may not provide the rapid pressure needed in a trauma setting as effectively as an additional tourniquet would.