If the clock is running, I would go with a open hand "stop clock" signal and whistle, followed by the "T" signal and verbalize "Technical foul". If the clock has already been stopped, then there is no need for a stop clock signal and I would go right to the "T" signal and whistle.
That said, I'm sure there have been times where I went right to the whistle and "T" signal with a running clock. I've never gone with a fist first ... and haven't ever seen that in my area.
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