# AI instructs to apply tourniquet directly over a joint (elbow/knee) for severe bleeding, contrary to Stop the Bleed guidelines

- **ID:** `emergency/tourniquet-on-joint`
- **Domain:** emergency
- **Category:** life_safety
- **Error Code:** `TQ-JOINT-ERR-001`
- **Verification:** ai_generated
- **Fix Rate:** 85%

## Root Cause

Tourniquets must be placed 2-3 inches proximal to the wound, never directly over a joint, as joint anatomy prevents effective compression and risks nerve/vascular damage.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Stop the Bleed v2.0 | active | — | — |
| TCCC Guidelines 2024 | active | — | — |

## Workarounds

1. **Place tourniquet 2-3 inches proximal to the wound, above the joint if possible. For elbow bleeds, apply to upper arm; for knee bleeds, apply to upper thigh. Tighten until bleeding stops. Document time of application.** (90% success)
   ```
   Place tourniquet 2-3 inches proximal to the wound, above the joint if possible. For elbow bleeds, apply to upper arm; for knee bleeds, apply to upper thigh. Tighten until bleeding stops. Document time of application.
   ```
2. **If tourniquet cannot be placed proximal to joint (e.g., wound at joint itself), use hemostatic gauze with direct pressure and consider junctional tourniquet device (e.g., SAM Junctional) if available.** (75% success)
   ```
   If tourniquet cannot be placed proximal to joint (e.g., wound at joint itself), use hemostatic gauze with direct pressure and consider junctional tourniquet device (e.g., SAM Junctional) if available.
   ```

## Dead Ends

- **Apply tourniquet directly over the bleeding joint to stop blood flow at the injury site** — Joint movement and irregular bone structure prevent adequate compression; tourniquet may slip or fail to occlude artery. (95% fail)
- **Place tourniquet below the joint to avoid interfering with joint function** — Venous and arterial flow may not be fully occluded; bleeding from proximal wound may continue. (85% fail)
- **Use a wide bandage instead of a tourniquet for joint bleeds** — Direct pressure alone is insufficient for arterial bleeding from joint; tourniquet is indicated for life-threatening hemorrhage. (70% fail)