OK. So looking at this PPT on tactical field care (specifically slides 71-78) it appears that the TQ should NOT be reduced if

- There is a traumatic amputation

- Casualty is in shock

- TQ has been on more than 6hrs

- Higher care will be reached with two hrs of applying

- Other considerations make reducing the TQ a bad idea.

Reduce only if

- Bleeding can be controlled by other means (slowly loosen and observe for renewed bleeding)

- You're a medic/doc