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A tourniquet should be used in cases of severe limb bleeding that cannot be controlled by direct pressure, as it is a critical intervention for managing life-threatening hemorrhage. When direct pressure fails to stop the bleeding from a significant arterial injury, applying a tourniquet can effectively restrict blood flow to the affected limb. This action helps to minimize blood loss and can be life-saving in trauma situations where rapid control of bleeding is necessary.

Using a tourniquet has specific indications, particularly in traumatic injuries where the risk of exsanguination exists. Its application should follow clear guidelines, ensuring it is placed above the injury site and that the bleeding is monitored. Unlike the other scenarios mentioned, a tourniquet is not appropriate for minor injuries, as these typically do not warrant such invasive measures. In cases of shock, while managing bleeding is crucial, the first approach would generally involve controlling bleeding through direct pressure and other steps rather than immediately resorting to a tourniquet, unless severe bleeding is present. Lastly, the timing of the tourniquet application is paramount; it should be used as needed, rather than simply during transport, as proper management at the injury site is essential to optimize outcomes.