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Assessing the Current Generation of Tourniquets.

Shimon Katsnelson1, Jessie Oppenheimer1, Rafi Gerrasi2

  • 1Faculty of Medicine, Institute for Research in Military Medicine, The Hebrew University of Jerusalem and Israel Defense Forces Medical Corps, POB 12272, Jerusalem 91120, Israel.

Military Medicine
|February 25, 2020
PubMed
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Modern combat tourniquets, CAT Generation 7 (CAT7) and SAM Extremity Tourniquet (SAM-XT), provide superior hemorrhage control compared to the SOF Tactical Tourniquet Wide (SOFTT-W). Reduced slack is key to effective tourniquet application and life-saving interventions.

Area of Science:

  • Medical Devices
  • Trauma Care
  • Emergency Medicine

Background:

  • Tourniquet application is a critical life-saving procedure in emergency medicine.
  • Previous tourniquet designs have limitations, particularly loose application before windlass activation.
  • New generation combat tourniquets aim to improve efficacy and address design flaws.

Purpose of the Study:

  • To assess the effectiveness of three modern combat tourniquet designs: CAT Generation 7 (CAT7), SAM Extremity Tourniquet (SAM-XT), and SOF Tactical Tourniquet Wide (SOFTT-W).
  • To evaluate the correlation between tourniquet effectiveness and the degree of slack during application.

Main Methods:

  • Three tourniquet models (CAT7, SAM-XT, SOFTT-W) were applied in a randomized sequence on a leg tourniquet trainer.
  • Simulated an above-the-knee traumatic amputation scenario with 60 military medicine cadets.

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  • Measured applied pressure, hemorrhage control status, time to bleeding cessation, estimated blood loss, and device slack.
  • Main Results:

    • SAM-XT (186 mmHg ±63) and CAT7 (175 mmHg ±79) applied significantly higher pressure than SOFTT-W (104 mmHg ±101).
    • Hemorrhage control rates were significantly better for SAM-XT (73.3%) and CAT7 (67.7%) compared to SOFTT-W (35%).
    • Less slack was strongly correlated with improved hemorrhage control and higher applied pressure (Pearson's r = -0.83).

    Conclusions:

    • SAM-XT and CAT7 demonstrated superior pressure application and hemorrhage control compared to SOFTT-W.
    • No significant difference in effectiveness was found between SAM-XT and CAT7.
    • Reduced slack during application is a critical factor for effective tourniquet performance.