Tourniquet Responsibility Brings Extra Stress Load, New Study Finds

Print Friendly, PDF & Email

A research team headed by a certified Force Science Analyst has explored an important concern that may be overlooked in typical field-medicine training for LEOs: How much extra stress is inflicted on an officer who needs to apply a tourniquet to a severely injured colleague?

This question was investigated recently in Scottsdale, AZ, with the help of 236 police volunteers.

The study, believed to be the first of its kind, was headed by Force Science grad Todd Larson, a retired Scottsdale PD lieutenant who is now director of the Simulator Training Lab operated by the HonorHealth medical services network. The HonorHealth Trauma Dept. partnered in the research, and Force Science instructor Dr. Matthew Sztajnkrycer, an emergency medicine specialist with the Mayo Clinic, consulted on the project as a subject-matter expert.


Of the volunteers, all sworn personnel with Scottsdale PD, 85% were male, mostly in the 21-40 age range, with nearly 75% on the job for 15 years or less. Five per cent reported getting no regular exercise; the others followed a fitness routine from one to five or more times a week.

A minority (28%) had been in the military, had military medical experience (2%), and had been “deployed in a war-type setting” (14%). Less than 10% reported other prior medical experience.

About half had received some tourniquet training, and most reported a mid-level confidence in their ability to properly apply this potentially life-saving device.


First in Larson’s study, Air Force registered nurses took the participants’ blood pressure and pulse to establish baselines. Then after 45 minutes of lecture and videos on tourniquet use and a practice session, the officers were paired for live, stress-inducing scenarios. Some participants were fitted with heart monitors.

Sitting in a patrol car, the teams one at a time hear radio traffic of a hot call, an active shooter in progress. An unseen officer responds, gets into a gunfight, and calls out that he is hit in the leg. Then his radio goes quiet.

When the test officers rush to the scene, they enter a shoot-house made up like a drug store/pharmacy. Immediately inside, they’re assailed by gunfire (safety blanks from training guns) and battle to incapacitate the attacker. Once he’s down, they search for and find the wounded officer, bleeding profusely.

This “officer” is, in fact, a “high-fidelity simulator,” a highly sophisticated, computerized medical training manikin that can produce a stunning array of human qualities. Among other things, it can breathe, talk, register heart tones and a palpable pulse, bleed, and respond to treatment.

In this case, the injured “officer” speaks briefly, then “passes out, in shock.” One officer from each team must apply a tourniquet to stanch the dangerous hemorrhaging, while his partner provides cover and conducts radio communication.

After the scenario, the participants’ vitals were checked again.


“We found statistically significant physiological differences between officers who had to manage the tourniquet and those who simply provided cover,” Larson told Force Science News. “Both had come under ‘gunfire’ that simulated a life threat and, of course, that boosted their stress levels. But the act of providing emergency medical care with the tourniquet added an additional layer of stress on top of that. The physiological effect on the tourniquet officer’s body was very high.”

The average heart rate for cover officers, for example, rose from 78 bpm before the scenario to more than 98 bpm afterward, an increase of about 26%. But for tourniquet officers, the increase spiked by nearly 40%, up from about 77 bpm to more than 107. “Those wearing heart monitors spiked to nearly 200 beats per minute in some cases,” Larson says.

Likewise, his team found that tourniquet placers on average had statistically significant elevations of blood pressure beyond what the cover officers experienced.

Larson points to three major correlations in the findings:

  • Age: Older officers tended to “perform better” (i.e., “showed less physiological stress”) than younger officers;
  • Tenure: Those with 10 or more years of service performed better;
  • Medical experience: Those who had prior medical experience (including military medical) performed better.

“An officer over 50 years old with 20-plus years on the job who has prior medical training appeared less impacted by physiological stress during tourniquet application,” Larson summarizes.

Confidence level going in, incidentally, proved to have “no correlation to actual stress reaction or performance,” Larson says.


HonorHealth researchers and Dr. Sztajnkrycer will be mining the research data for other relevant information, Larson says. Meanwhile, Larson offers these observations on the findings in hand:

“When we add a medical component to an officer’s responsibilities in a high-stress situation, we have to recognize that we are significantly increasing that officer’s physiological load and that his or her human performance may be degraded as a result.

“We can’t just hand an officer a tourniquet and say, ‘Use it when you need it.’ There must be training and practice, and not just one-time training either. And just like in shooting situations, we can’t expect that officers are always going to make perfect decisions when their body is under stress.

“Tourniquet proficiency is important. There are many critical situations in today’s world that just won’t wait until EMS arrives. Officers need to be prepared to stop serious bleeding on themselves, on partners, and on civilian victims. You never know when that moment is going to hit.”

Case in point: Shortly after participating in Larson’s research, one of the officer volunteers received an urgent “subject with a knife” call. “A male subject had sliced an artery in cutting his arm to the bone with a bread knife,” Larson says. “He was starting to pass out when the officer arrived.

“The officer applied a tourniquet and stopped the bleeding. Without that, the subject absolutely would have died.”

For more information, Todd Larson can be reached at: Todd.Larson@HonorHealth.com. HonorHealth plans to pursue publication of this research in a professional journal. The initial findings will be presented at the Emergency Medical Services Odyssey Conference on June 9 in Phoenix.

Leave a Reply


  • Privacy Policy

Privacy Policy

Effective date: January 06, 2019

Force Science Institute, Ltd. (“us”, “we”, or “our”) operates the https://www.forcescience.org/ website (hereinafter referred to as the “Service”).

This page informs you of our policies regarding the collection, use, and disclosure of personal data when you use our Service and the choices you have associated with that data. Our Privacy Policy for Force Science Institute, Ltd. is based on the Privacy Policy Template from Privacy Policies.

We use your data to provide and improve the Service. By using the Service, you agree to the collection and use of information in accordance with this policy. Unless otherwise defined in this Privacy Policy, the terms used in this Privacy Policy have the same meanings as in our Terms and Conditions, accessible from https://www.forcescience.org/

Information Collection And Use

We collect several different types of information for various purposes to provide and improve our Service to you.

Types of Data Collected

Personal Data

While using our Service, we may ask you to provide us with certain personally identifiable information that can be used to contact or identify you (“Personal Data”). Personally identifiable information may include, but is not limited to:

  • Email address
  • First name and last name
  • Phone number
  • Address, State, Province, ZIP/Postal code, City
  • Cookies and Usage Data

Usage Data

We may also collect information on how the Service is accessed and used (“Usage Data”). This Usage Data may include information such as your computer’s Internet Protocol address (e.g. IP address), browser type, browser version, the pages of our Service that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data.

Tracking & Cookies Data

We use cookies and similar tracking technologies to track the activity on our Service and hold certain information.

Cookies are files with small amount of data which may include an anonymous unique identifier. Cookies are sent to your browser from a website and stored on your device. Tracking technologies also used are beacons, tags, and scripts to collect and track information and to improve and analyze our Service.

You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our Service. You can learn more how to manage cookies in the Browser Cookies Guide.

Examples of Cookies we use:

  • Session Cookies. We use Session Cookies to operate our Service.
  • Preference Cookies. We use Preference Cookies to remember your preferences and various settings.
  • Security Cookies. We use Security Cookies for security purposes.

Use of Data

Force Science Institute, Ltd. uses the collected data for various purposes:

  • To provide and maintain the Service
  • To notify you about changes to our Service
  • To allow you to participate in interactive features of our Service when you choose to do so
  • To provide customer care and support
  • To provide analysis or valuable information so that we can improve the Service
  • To monitor the usage of the Service
  • To detect, prevent and address technical issues

Transfer Of Data

Your information, including Personal Data, may be transferred to — and maintained on — computers located outside of your state, province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction.

If you are located outside United States and choose to provide information to us, please note that we transfer the data, including Personal Data, to United States and process it there.

Your consent to this Privacy Policy followed by your submission of such information represents your agreement to that transfer.

Force Science Institute, Ltd. will take all steps reasonably necessary to ensure that your data is treated securely and in accordance with this Privacy Policy and no transfer of your Personal Data will take place to an organization or a country unless there are adequate controls in place including the security of your data and other personal information.

Disclosure Of Data

Legal Requirements

Force Science Institute, Ltd. may disclose your Personal Data in the good faith belief that such action is necessary to:

  • To comply with a legal obligation
  • To protect and defend the rights or property of Force Science Institute, Ltd.
  • To prevent or investigate possible wrongdoing in connection with the Service
  • To protect the personal safety of users of the Service or the public
  • To protect against legal liability

Security Of Data

The security of your data is important to us, but remember that no method of transmission over the Internet, or method of electronic storage is 100% secure. While we strive to use commercially acceptable means to protect your Personal Data, we cannot guarantee its absolute security.

Service Providers

We may employ third party companies and individuals to facilitate our Service (“Service Providers”), to provide the Service on our behalf, to perform Service-related services or to assist us in analyzing how our Service is used.

These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose.


We may use third-party Service Providers to monitor and analyze the use of our Service.

  • Google AnalyticsGoogle Analytics is a web analytics service offered by Google that tracks and reports website traffic. Google uses the data collected to track and monitor the use of our Service. This data is shared with other Google services. Google may use the collected data to contextualize and personalize the ads of its own advertising network.You can opt-out of having made your activity on the Service available to Google Analytics by installing the Google Analytics opt-out browser add-on. The add-on prevents the Google Analytics JavaScript (ga.js, analytics.js, and dc.js) from sharing information with Google Analytics about visits activity.For more information on the privacy practices of Google, please visit the Google Privacy & Terms web page: https://policies.google.com/privacy?hl=en

Links To Other Sites

Our Service may contain links to other sites that are not operated by us. If you click on a third party link, you will be directed to that third party’s site. We strongly advise you to review the Privacy Policy of every site you visit.

We have no control over and assume no responsibility for the content, privacy policies or practices of any third party sites or services.

Children’s Privacy

Our Service does not address anyone under the age of 18 (“Children”).

We do not knowingly collect personally identifiable information from anyone under the age of 18. If you are a parent or guardian and you are aware that your Children has provided us with Personal Data, please contact us. If we become aware that we have collected Personal Data from children without verification of parental consent, we take steps to remove that information from our servers.

Changes To This Privacy Policy

We may update our Privacy Policy from time to time. We will notify you of any changes by posting the new Privacy Policy on this page.

We will let you know via email and/or a prominent notice on our Service, prior to the change becoming effective and update the “effective date” at the top of this Privacy Policy.

You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when they are posted on this page.

Contact Us

If you have any questions about this Privacy Policy, please contact us:

  • By email: support@forcescience.org
  • By visiting this page on our website: https://www.forcescience.org/contact
  • By phone number: 866-683-1944
  • By mail: Force Science Institute, Ltd.