Comparing the performance of tourniquet application between self-aid and buddy-aid: in ordinary and simulated scenarios

Combat Application Tourniquet (CAT) is generally applied by self-aid or buddy-aid for exsanguinating extremity hemorrhage. The purpose of this study was to compare the accuracy, time and effectiveness between self-aid and buddy aid in ordinary and simulated scenarios.

A total of 64 undergraduates from the Red Cross Commando of a military medical university participated in this study, which involved ordinary and simulated scenarios. In each scenario, every participant completed tourniquet application to upper and lower extremities by self-aid and buddy-aid, respectively. Measures of time, accuracy and effectiveness were assessed by an examiner identically after each application.

Compared with the performance of CAT application by buddy-aid, the time of application to upper extremities by self-aid increased by 8.39 s (P<0.001) and 3.24 s to lower extremities (P<0.05), and the percentage of pulse elimination by self-aid declined by 13.29% and 10.93% to both upper and lower extremities, respectively (P<0.05). Simulated combat performance showed longer time and lower accuracy (P<0.05).

The hypothesized different performances between self-aid and buddy-aid, as well as between ordinary and simulated scenarios were verified in this study, indicating the need for superior tourniquet design for self-aid and rigorous deployment readiness training, especially for self-aid in tourniquet application.