If indicated, the properly applied tourniquet can save the life, but endangers the limb. A common mistake with tourniquets is inadequate compression, which occludes the veins but fails to occlude the artery, resulting in all increased rate of blood loss. The tourniquet should be placed as distally as possible on the extremity, just proximal to the wound. Once in place and adequately controlling hemorrhage, it should not be released until the casualty reaches the operating room. When applied in the field or enroute, the time of tourniquet application should be recorded on the field medical card.
Some controversy still surrounds their use.
MAST trousers can produce ischemia and compartment syndromes if improperly used. A recent combat casualty with abdominal wounds and no lower extremity wounds was treated with MAST trousers in addition to fluid resuscitation and operation. Instability was such that the trousers were left inflated for 18 hours. This casualty subsequently required bilateral above knee amputations. The trousers should never be inflated beyond 100 mm Hg.