Page 47 - Journal of Special Operations Medicine - Winter 2015

Table 3 Tourniquet Mechanical Advantage System Use at Figure 6 (A) 120-second Pressures of all four tourniquets.
Completion* (B) Loss of pressure from Completion to 120-seconds. All
tourniquets had some pressure loss. The SWATT had the
Windlass Turns, Ladder Teeth, least pressure loss. The CAT and RMT-P had smaller pressure
SWATT Wraps
Tourniquet Location (median, minimum–maximum) losses over 120 seconds on the forearms than on the calves
(p < .0001 each).
CAT Calf 2, 1–4
SOFTT-W Calf 3, 2–4 (A)
RMT-P Calf 6.5, 4–9
SWATT Calf 5.25, 3.5–6.25
CAT Forearm 1, 0–3
SOFTT-W Forearm 2, 2–3
RMT-P Forearm 3, 0–5
SWATT Forearm 6, 4.5–7.5
See Table 2 legend for expansion of abbreviations.
*p = .0066 for CAT calf versus SOFTT-W calf; p = .0002 for CAT
forearm versus SOFTT-W forearm; p = .0032 for CAT calf versus fore-
arm; p = .015 for SOFTT-W calf versus forearm; p < .0001 for RMT-P
calf versus forearm; p = .0008 for SWATT calf versus forearm.

Table 4 Tourniquet Ease of Application*
Rating = Rating = Rating =
Easy, Challenging, Difficult,
Tourniquet Location No. No. No.
CAT Calf 16 0 0
SOFTT-W Calf 5 9 2
RMT-P Calf 16 0 0
(B)
SWATT Calf 12 4 0
CAT Forearm 15 0 1
SOFTT-W Forearm 10 2 4
RMT-P Forearm 16 0 0
SWATT Forearm 14 2 0
See Table 2 legend for expansion of abbreviations.
*p < .0001 for combined calf and forearm differences in ease of ap-
plication between tourniquets.

hook-and-loop strap near the plastic base. The CAT
base does not twist; the entire width of the base and
of the hook-and-loop remains in contact with the limb
during windlass tightening.

Tightening the SOFTT-W windlass results in some twist-
ing of the webbing base of the SOFTT-W in addition to
twisting of the 3.8cm-wide strap. Twisting of the base
and of the strap results in a decreased limb-surface con-
tact area against which the tourniquet pressure is exerted.
Tourniquet Completion Comments
Tightening of the RMT-P via advancing the ratchet- Securing the CAT windlass in its windlass securing clip is
ing buckle resulted in the formation of a few discrete relatively easy. The backward travel of the windlass, once
bunches of the strap underneath the ladder. The bunches it is placed into the opening of the clip, can allow a Com-
increased in size with increasing ratcheting buckle use. pletion Pressure that is lower than the Occlusion Pressure.
No portion of the RMT-P twists, so the entire 3.8cm
width remains in contact with the limb during ratchet Securing the SOFTT-W windlass in the windlass se-
tightening. curing triangle can be difficult. Two appliers needed

Emergency Tourniquets on Distal Limb Segments 35