# AI instructs to apply tourniquet directly over a joint (elbow/knee) for severe bleeding, contrary to Stop the Bleed guidelines which require placement 2-3 inches above the wound, never over a joint

- **ID:** `emergency/tourniquet-over-joint`
- **Domain:** emergency
- **Category:** config_error
- **Error Code:** `TOURNIQUET-JOINT-ERR-006`
- **Verification:** ai_generated
- **Fix Rate:** 93%

## Root Cause

Tourniquets over joints are ineffective because the joint's bony prominence prevents sufficient compression of arteries; blood continues to flow around the joint. The correct placement is 2-3 inches above the wound on a single-bone segment (upper arm or thigh).

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Stop the Bleed 2023 guidelines | active | — | — |
| CAT Gen7 tourniquet | active | — | — |
| SOF Tactical Tourniquet | active | — | — |

## Workarounds

1. **Apply tourniquet 2-3 inches above the wound, never over a joint. For forearm wound, place on upper arm (between shoulder and elbow). For lower leg wound, place on thigh (between hip and knee). Tighten until bleeding stops. Example: use CAT Gen7, thread strap through buckle, twist windlass until bleeding ceases, secure windlass, note time.** (95% success)
   ```
   Apply tourniquet 2-3 inches above the wound, never over a joint. For forearm wound, place on upper arm (between shoulder and elbow). For lower leg wound, place on thigh (between hip and knee). Tighten until bleeding stops. Example: use CAT Gen7, thread strap through buckle, twist windlass until bleeding ceases, secure windlass, note time.
   ```
2. **If wound is on a joint (e.g., elbow laceration), use hemostatic gauze (e.g., QuikClot) packed directly into wound with direct pressure, then wrap with pressure bandage. Tourniquet cannot be used effectively on joints.** (85% success)
   ```
   If wound is on a joint (e.g., elbow laceration), use hemostatic gauze (e.g., QuikClot) packed directly into wound with direct pressure, then wrap with pressure bandage. Tourniquet cannot be used effectively on joints.
   ```

## Dead Ends

- **** — The elbow's olecranon process prevents the tourniquet from compressing the brachial artery; blood flow continues via collateral circulation. Bleeding does not stop. (98% fail)
- **** — The patella and popliteal fossa create gaps that prevent arterial compression; the tourniquet slips or fails to occlude flow. Also risks nerve damage (common peroneal nerve). (97% fail)
- **** — Narrow materials cut into skin and cause severe tissue damage without achieving hemostasis; they are also more likely to slip off the joint contour. (99% fail)