I agree with your take on the TQ in an urban environment. Very few instances apart from traumatic injuries (amputation or partial amputation) would require the application of a TQ. They are also limited to limb injuries. Never use on a neck bleed . Direct pressure works sometimes on minor to medium bleeds, for anything above, less efficient, but still useful. When it comes to FA, I always try to impart the following on people when it comes to FA and medical interventions: The fact that you can buy the kit doesn't mean you can or should use it and even carry it. This is why some kits/items are only available to professional and/or under prescription from a Doc. Kit acquisition should always come with proper training. The corollary to that, as I mentioned in my post, is that to use a TQ, you have to know how and when. In FA there is a definite potential to do more harm if you engage in "care" without knowledge. You have most likely heard of the Motto: Do No Harm, Do Know Harm.... As an aside, I strongly believe that First aid, CPR and the use of AED, (even though they are pretty much "moron proof") should be thought in school.