Page 33 - Journal of Special Operations Medicine - Summer 2014

Results throughout the duration of compression (Figures 3 and
4). Release of pressure from either manual compression
In the experimental control, an average of 139mmHg or TCD use on the target point immediately restored
of pressure in manual compression at the inguinal liga- blood flow. Prompt restoration indicated that the arter-
ment stopped blood flow in the distal external iliac ar- ies were not torn or damaged by the compression or the
tery (Table 1).
release of pressure.

Table 1 Experimental Control Data of Manual Pressure at Table 3 Experimental Control Data of Manual Pressure to
Occlusion in Inguinal Use Occlusion in Axillary Use
Manual Pressure to Occlude
Cadaver (mmHg) Cadaver Manual Pressure to Occlude
(mmHg)
1 115 3 1228
1 140 3 1152
2 160 3 1331
2 125 Average ± SD 1237 ± 89.8
2 155
Average ± SD 139 ± 19.1

Discussion
In SJT use, an average of 107mmHg occluded the distal The main finding of the present study is that the SJT was
external iliac artery at the inguinal ligament in an aver- shown to be a safe and effective hemorrhage control de-
age of 7 seconds of inflation time (Table 2). vice in a perfused cadaver model in both the axillary and
inguinal areas. The SJT’s TCDs require pressures ap-
In the experimental control, an average of 1237mmHg proximately equal to or lower than manual pressure to
of pressure in manual compression stopped blood flow achieve hemostasis in the junctional regions. The TCDs,
in the axillary artery (Table 3). In SJT use, an average of which are pneumatic point pressure devices of the SJT,
739mmHg in TCD use occluded the axillary artery at achieve hemorrhage control quickly and consistently in
the target point in an average of 5 seconds of inflation a human cadaveric model.
time (Table 4). In one inguinal trial, bleeding stopped
as soon as the buckle was secured and no inflation On the modern battlefield, foot Soldiers and, in particu-
was necessary—the point pressure from the uninflated lar, medics are challenged in prioritizing decisions about
TCD (76mmHg) was adequate. In this trial, the time the loads they carry and available packing space for
to occlude the vessel and control hemorrhage was thus items like a potentially life-saving medical device such
0 seconds. On the inguinal trials, the number of hand as the SJT. Many items are considered, but only a few
pumps required to inflate the TCD and achieve hem- can be carried and packed. The SJT, however, is a device
orrhage control was four, none, six, two, five, and six, with multiple indications. A multiple-use device may be
respectively. more likely to be useful and therefore fielded and car-
ried. With greater availability, such devices are therefore
No repositioning of the SJT or its TCD was necessary to more likely to be used in care and thus more likely to
achieve hemorrhage control, and pressure was sustained save more lives.

Table 2 SJT Trial Data in Inguinal Use
Time to Maximum Pressure
Hemorrhage Control ≥45 Seconds Under Device Rebleed After
Trial Cadaver (sec) Hemostasis? (mmHg) Release?
1 1 2 Yes 150 Yes
2 2 0 Yes 76 Yes
3 2 3 Yes 85 Yes
4 2 2 Yes 70 Yes
5 2 25 Yes 94 Yes
6 2 10 Yes 164 Yes
Average ± SD 7 ± 9.5 106 ± 40.2

SAM Junctional Tourniquet to Control Inguinal Hemorrhage 23
®