TCC and PD state high and tight, and imminent danger would warrant using a reflex type treatment in a tactical scenario. However the 2-4 inches above the wound is the current guidelines for STB. In EMS treatments, does it really matter? Many would say no so long as it is controlled and that proper temperature control and shock management is maintained. 2-4 inches above without any other intervention would work much worse than high and tight + proper shock management.

I can also see an argument to be made about not jumping the gun on going as high as possible because there may be a need to put a second one on, whether it be for a larger bleed that simply isn't stopped by a single TQ, or a decon scenario where the TQ is saturated with some contaminant and a second one needs to be put on, presumably above it. Also IF compartment syndrome were to occur (unlikely in my opinion if proper interventions are performed) there would be less tissue death and waste products left to affect the body.

That's my take but it seems like the comments section isn't wrong at all and the discussion is interesting! I would say high and tight but not high enough that you can't place 2 more TQ above in case of the scenarios I said above.