This form is intended to assist NTRAC in surveillance of the Stop the Bleed tourniquet training. Please fill out this form completely after each use of a tourniquet, including improvised tourniquets. Do not place any protected health information on this form. This information will be kept secure and used for process improvement and data collection only.
|Q4||Was Stop the Bleed training used|
|Q5||Style of tourniquet used|
|Q6||Was application successful|