Studies Show that Current Military Tourniquets are Inherently Flawed

[BK14]

Obviously a poor excuse for a scientific article loaded with emotional language....

I’ve never done a real-world application of a Rats TQ, but I have of the Swat-T, and two applications of the Soft Wide. Swat-t sucked to apply, and wasn’t extremely effective, it was to a femoral bleed.... Both Soft applications were to an arm with a brachial bleed. Both Soft applications were quick, easy, and stopped the bleed.

I carry a Soft on my belt, and a Soft and Swat-t on my vest.

In the article it referenced the Israeli study, with students not cranking hard enough. The answer seems easy, train them better. In my experience, throw on the TQ, tighten the strap as much as possible, then crank until you can’t anymore on the windlass, then keep tightening it more and secure it.

(Not a doctor, not legally/medically liable for you, etc).

[ST911]

The answer seems easy, train them better. In my experience, throw on the TQ, tighten the strap as much as possible, then crank until you can’t anymore on the windlass, then keep tightening it more and secure it.

Good example of why that's not the solution, and actually part of the problem. The windlass should be tightened until the arterial bleeding stops.

Tightening until you can't anymore is what can injure the patient and break the TQ. This is a common variable in the enviro/UV exposed CAT failures, along with failure of velcro adhesion with the CAT is carried exposed improperly. Elastic TQs have no tension regulation or increments at all.

At the other extreme, the USAF's Self Aid Buddy Care (SABC) curriculum teaches to tighten the windlass no more than three times. Three might work on a decent application to certain arms. I don't remember it ever occluding on a leg. It also won't work when airman makes one of the leading errors in TQ application- failure to pull enough tension on the strap itself, leading to the ball of ribbon/strap under the windlass.

(And while we're talking about the USAF: Certain units at Global Strike bases are using the GSC spec'ed packing list in First Spear's outstanding MTAP kit. However that bag ships with two different TQ types, the TK4 and TMT. Now add existing CATs already in the units, many of which will either not have been opened from the legacy IFAKs or not have been rotated in lengthy period of time. There may be unit level purchases of a SOFTT-W variant. Airman now has at least three TQ types to use, possibly four, and a high likelihood that his last training on them was a CBT or the typical "we all know this but we have to talk about it anyway" ppt training.)

Summary: Like much else, it's not the gear that's failing as much as the training and leadership. Gear mitigates and aggravates, but people continue to fail people.

[jetfire]

Oh holy shit, is that a high femoral bone break?

[Poconnor]

I have two friends whose lives were saved by tourniquets on their legs. One infantryman, one policeman. Both muscular guys that required two tourniquets. The infantryman was an ied in Iraq. The police officer was a 12 gauge hit of bird shot to the thigh. I had to fight to get tourniquets issued at my police department. The resistance was surprising

[BK14]

The windlass should be tightened until the arterial bleeding stops.

Tightening until you can't anymore is what can injure the patient and break the TQ.

Thanks for the clarification. I’ll edit my post to clarify my intention.

I have very little exposure with a CAT, but plenty of guys I work with carry them, so I should probably train on them more. Obviously, tighten until the bleed stops, but in the applications I had, the bleeding didn’t stop until after the windlass was about maxed out on the Soft. That was all I was trying to convey.

[JHC]

I'm glad that someone else posted this ahead of me, because I was getting ready to load up and drop bombs. The short version is that the scumbag who invented the RATS tourniquet cherry picked a shitload of anecdotes and then created and published this "evidenced based medicine" site in order to discredit CAT and SOFT-T TQs.

Why would he want to do that? Well I can only assume based on his tactics that it's because he's a scumbag.

Havok Journal getting after it
https://havokjournal.com/nation/fake...43hbFqeI0VWKOk

[KPD]

The Trauma Surgeons at our Level 1 Trauma Center have expressed two complaints about CATS and SOFTT tourniquets. 1. We don’t get them tight enough and 2.) We don’t use them often enough.

These are the only two consistent complaints I have heard from ER Doctors and Surgeons. I have never heard anyone from these groups of Doctors criticize the designs.

[sandy11B3V5W]

I guess I'm skeptical. With the prevalence of victim detonated pressure plates, we have seen just how effective our tourniquets are. Double and triple amputees have survived because of their effective use.

I believe most of the hardware shortcomings have been addressed with a beefed up windlass and a thicker more simple friction adapter that routes faster and makes effective application faster and easier on the newer models.

[JHC]

The Trauma Surgeons at our Level 1 Trauma Center have expressed two complaints about CATS and SOFTT tourniquets. 1. We don’t get them tight enough and 2.) We don’t use them often enough.

These are the only two consistent complaints I have heard from ER Doctors and Surgeons. I have never heard anyone from these groups of Doctors criticize the designs.

My 11B son has had a good bit of training in the use of these and has passed on to me that they've been admonished that the failures in tightness are often/usually(?) due to not winching down the strap extremely tight BEFORE even starting to use the windlass. The live training they do is rather uncomfortable.

[BigD]

Both muscular guys that required two tourniquets.

I don't think this gets talked about enough. I just had some remedial training from 18Ds and they were quick to point out that it often takes multiple tourniquets to stop a femoral bleed.

Not such a problem in the military where I always had multiple TQs on me and my teammates had multiple TQs. We weren't likely to run out.

But, now that I don't wear a uniform I'll admit that I don't always have a single TQ on me depending on dress, where I'm going, etc, much less two.

I think the take away is you need additional TQs in every daypack, diaper bag, vehicle, wife's purse, etc., to increase the odds that you can get your hands on a second TQ as quickly as possible.