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The Efficacy of Novel Commercial Tourniquet Designs for Extremity Hemorrhage Control: Implications for Spontaneous Responder Every Day Carry

Published online by Cambridge University Press:  13 April 2020

Joshua Ellis ,
Melissa M. Morrow ,
Alec Belau ,
Luke S. Sztajnkrycer ,
Jeffrey N. Wood ,
Tobias Kummer  and
Matthew D. Sztajnkrycer Open the ORCID record for Matthew D. Sztajnkrycer [Opens in a new window]
Joshua Ellis
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Melissa M. Morrow
Affiliation:
Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MinnesotaUSA
Alec Belau
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Luke S. Sztajnkrycer
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Jeffrey N. Wood
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Tobias Kummer
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Matthew D. Sztajnkrycer*
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
*
Correspondence: Matthew D. Sztajnkrycer, MD, PhD, Professor of Emergency Medicine, Mayo Clinic GE-GR-G410, 200 1st Street SW, Rochester, Minnesota55905USA, E-mail: sztajnkrycer.matthew@mayo.edu
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Abstract

Introduction:

Tourniquets (TQs) save lives. Although military-approved TQs appear more effective than improvised TQs in controlling exsanguinating extremity hemorrhage, their bulk may preclude every day carry (EDC) by civilian lay-providers, limiting availability during emergencies.

Study Objective:

The purpose of the current study was to compare the efficacy of three novel commercial TQ designs to a military-approved TQ.

Methods:

Nine Emergency Medicine residents evaluated four different TQ designs: Gen 7 Combat Application Tourniquet (CAT7; control), Stretch Wrap and Tuck Tourniquet (SWAT-T), Gen 2 Rapid Application Tourniquet System (RATS), and Tourni-Key (TK). Popliteal artery flow cessation was determined using a ZONARE ZS3 ultrasound. Steady state maximal generated force was measured for 30 seconds with a thin-film force sensor.

Results:

Success rates for distal arterial flow cessation were 89% CAT7; 67% SWAT-T; 89% RATS; and 78% TK (H 0.89; P = .83). Mean (SD) application times were 10.4 (SD = 1.7) seconds CAT7; 23.1 (SD = 9.0) seconds SWAT-T; 11.1 (SD = 3.8) seconds RATS; and 20.0 (SD = 7.1) seconds TK (F 9.71; P <.001). Steady state maximal forces were 29.9 (SD = 1.2) N CAT7; 23.4 (SD = 0.8) N SWAT-T; 33.0 (SD = 1.3) N RATS; and 41.9 (SD = 1.3) N TK.

Conclusion:

All novel TQ systems were non-inferior to the military-approved CAT7. Mean application times were less than 30 seconds for all four designs. The size of these novel TQs may make them more conducive to lay-provider EDC, thereby increasing community resiliency and improving the response to high-threat events.

Keywords

every day carryhemorrhage controlmass-casualty incidentspontaneous respondertourniquet
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 3 , June 2020 , pp. 276 - 280
Copyright
© World Association for Disaster and Emergency Medicine 2020

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