Page 19 - Journal of Special Operations Medicine - Winter 2014

this instance, the wound also fit the indication for the
Figure 5 iTClamp. With this in mind, the medic chose to use the
iTClamp instead of a tourniquet. The iTClamp was ap-
plied to the entrance wound site with immediate external
hemorrhage control. No further hematoma expansion
was noted during transport to the operating room. The
patient did not complain about application, and once in
the operating room, the surgeon stated that wound ex-
ploration, interventions, and vessel repair were greatly
eased due to the lack of a tourniquet, hemostatic gran-
ules, or gauze packing.

Case 2
A second male non-US combatant, approximately 28
years old, presented with what was apparently a shrap-
nel or ricochet injury to the lower left anterior medial
thigh. The wound had visible arterial and venous hem-
orrhage from a laceration with fragment penetration of
unknown depth. The patient was combative but denied
pain for the duration of treatment and transport. Ineffec-
tive and intermittent manual direct pressure was applied
by the patient prior to examination. Similar to the previ-
ous example, either a tourniquet or an iTClamp could
have been used on this wound, but the medic chose to
use the iTClamp. The iTClamp 50 was applied to the
penetrating portion of the wound, covering the majority
of the superficial laceration as well. The portion of the
superficial laceration that was not covered by the clamp
was everted and the minor capillary hemorrhage was
Figure 6 inconsequential. The seal was effective and no external
hemorrhage was noted post application. The patient
had no complaint of pain before or after application,
is being removed for readjustment purposes only, it is and no visible reaction was noted during application.
ready to reapply at this point.

Discussion
With all this in mind, we set out to document two case
studies where the iTClamp 50 was successfully used in Hemorrhage control is an ever-present challenge to first
the military environment to control potentially fatal responders that has deadly consequences, and challenges
hemorrhage. are exacerbated in a military setting. These case studies
demonstrated that the iTClamp 50 quickly and success-
fully controlled a potentially fatal femoral arterial bleed
Case Presentations at the point of injury, resulting in the patient surviving
to reach more definitive care. iTClamp also successfully

Case 1 achieved hemostasis despite incomplete coverage of lac-
A male non-US combatant, approximately 26 years old, eration. However, in combative patients, as discussed
presented with a 7.62 AK-47 wound to the right inner earlier, restraints or an additional device securing mea-
(medial) thigh. The patient was alert and oriented, com- sures (ACE wrap, bandaging, etc.) should be applied to
plaining of pain in the upper right thigh. The wound prevent patient removal of the device.
tract created was a small entrance wound with no exit.
Prior to examination, a hematoma formed in the wound The strength of the iTClamp is that it can be applied in
tract, causing a noticeable deformation of the skin with orders of magnitude faster than existing devices, uses
no external hemorrhage. Upon movement and palpa- only gross motor skills, does not require clothing re-
tion, the wound began to hemorrhage externally with moval, and fills an unmet need in the CUF phase. Com-
clearly identifiable arterial flow. No intervention was pared with tourniquets, which can only treat injuries to
in place, and direct pressure had not been applied post distal limbs, are extremely painful, take time and skill to
wounding. While a tourniquet could have been used in apply, and cut off blood flow to the limb, the iTClamp

Tactical Hemorrhage Control Point-of-Care Device 9