The big wounds often involve a severed artery (high-pressure pipe that carries blood away from the heart). Direct pressure is often not enough to stop the bleeding in these right away, and the injured person is losing a lot of blood fast, so you don’t have the time to wait for it to work. Tieing a tourniquet above the bleeding will stop the bleeding if done correctly, and ideally, you would be holding direct pressure while doing this.
This would work for smaller wounds, too, but a tourniquet is very painful for the patient and could lead to what’s called a crush injury, where toxins build up over time in the blocked off extremity that cause serious complications.
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