He lurched backward, crumpled to the ground. His pants leg grew heavy with his blood.

Andrew Harriman, 24, grew up in Largo Fla. A graduate of Admiral Farragut Academy, he became an EMT for SunStar ambulance service at 18, joined the Army six months later.

Now just before 11 p.m. on March 26 he writhed in the dark, groping at his wound. He felt his life draining away through his leg.

As he lay beside the helicopter, he dug into the left pocket of his blood-sticky pants and yanked out a decidedly low-tech tool that has proved to be a lifesaver in this high-tech war: a tourniquet.

He always carried at least eight.

He slipped the black strap around his thigh, twisted the stick and cinched it tight, like a noose.

He felt his skin tissue compressing, bone crushing, "the greatest pain you can imagine; worse than the bullets." Almost instantly, his blood stopped spurting.

He saved his leg and his life.

"When I first got to my unit in 2004, they told us not to use tourniquets. They were a last resort," Harriman said. "But the thought on that has changed. I know I wouldn't be here if I hadn't put that one on."

Simple combat medical tool

In this modern war of bullet-proof vehicles, Kevlar body armor and blood-clotting bandages, soldiers are saving lives with one of the oldest and simplest tools of combat medicine.

Harriman applied tourniquets 24 times during his eight months in the war.

He saved an Iraqi police officer whose leg had been blasted through and a young Army specialist who was ambushed by insurgents.

When an anti-tank mine exploded beneath a truck of Iraqi soldiers, blowing limbs across the desert, Harriman applied 11 tourniquets.

Tourniquets have been used on battlefields for more than 300 years, but they had been shunned by the military since the end of World War II.

Now Army doctors say they're indispensable and they've begun designing more modern versions, including a type that can be tied with one hand. The Combat Application Tourniquet was named one of the Army's 10 greatest inventions for 2005.

Last year, every soldier sent to Iraq was issued one in his first aid kit.

For $19, you can buy one on eBay.

"We've seen a tremendous increase in the use of tourniquets across the entire Iraq-Afghanistan theater," U.S. Army Col. Brian Eastridge said recently from Baghdad. Eastridge, a trauma surgeon, travels to medical centers throughout the war zone.

"From soldiers to surgeons," he said, "there's no longer any question that tourniquets have saved hundreds of lives."

First applied in 1674

Named from the French verb tourner, to turn, tourniquets stop bleeding by crimping a severed artery. A French Army surgeon first tied one on a soldier in 1674. During the American Civil War, troops had to carry a 6-inch stick of wood and a handkerchief and know how to tie them into a tourniquet. The U.S. military issued rope-and-peg-style versions during the two world wars.

Then word started spreading: Tourniquets caused gangrene. Soldiers who waited 12, 20 hours, or even days to be evacuated to field hospitals lost limbs because their tourniquets were tied on too long. Doctors began denouncing them; medics stopped using them.

"A lot of our bad mojo about using tourniquets was just dogma from an era gone by," Eastridge said. "They became basically taboo in the U.S. because of the risk of limb loss. But if you're bleeding to death, obviously, we want to choose life over limb."

Hundreds of men maybe thousands who bled to death in Korea and Vietnam could have been saved, Army surgeons now say, with a device any Boy Scout could fashion with a bandanna and a stick.

You can bleed to death in 10 minutes. It takes 30 seconds to tie a tourniquet.

Many of the first deaths during the Iraq war were soldiers who lost a limb and bled to death in the field. Some soldiers tried to make tourniquets out of Ace bandages, bungee cords, rifle slings. But in the desert, they couldn't find sticks to twist them tight enough.

"We were seeing all kinds of improvised devices coming into the hospitals here," Eastridge said. Soldiers arrived with their thighs sheathed in wire, tightened around fuel can nozzles and tire irons. Others had tried to stave the bleeding with bandages.

Change of doctrine

Now that most of the injured are transported to medical centers within a few hours, the tourniquets don't have to be on long enough to lose limbs. So doctors decided they needed to clear the device of its bad name and come up with a better design.

It was the first time they'd been able to change doctrine during a war.

In 2004, during what was dubbed the "Tourniquet-Off," volunteers tested nine designs at the U.S. Army Institute of Surgical Research in San Antonio.

A pneumatic device, like a really tight blood-pressure cuff, couldn't withstand the dust from Iraqi deserts. Other versions couldn't be applied quickly enough. In the end, only three worked.

"We settled on the Combat Application Tourniquet, which has its own bar to twist and a Velcro strap to secure it," said Eastridge. "It's a simple, cheap device that has made a huge advance in the way we manage battlefield injuries."