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When applying a tourniquet, it is crucial to avoid removing the casualty's clothes. Clothing can often provide a barrier that may help in controlling bleeding and may also protect the wound from additional contamination. Removing clothes could expose the injury, which may worsen bleeding, increase the risk of infection, or disrupt any clot formation that is taking place.
On the other hand, while the tourniquet should be applied directly to the skin and tightened around the limb, it may be necessary to leave the clothes in place until more advanced medical personnel can take over. It’s important to maintain the integrity of the environment as much as possible while providing first aid.
In contrast, removing the tourniquet after it has been applied would defeat its purpose, and the bandage should also remain in place to manage wound care. Similarly, shoes may be left on unless they interfere with the application of a tourniquet in a way that requires them to be adjusted.