Page 30 - Journal of Special Operations Medicine - Spring 2016

Short Report Comparing Generation 6 Versus

Prototype Generation 7 Combat Application Tourniquet
®
in a Manikin Hemorrhage Model

John F. Kragh Jr, MD; Virgil K. Moore III, BBA; James K. Aden 3rd, PhD;
Donald L. Parsons, PA; Michael A. Dubick, PhD

ABSTRACT
Background: The Combat Application Tourniquet Resources; http://combattourniquet.com) is the standard-
®
(C-A-T) is the standard-issue military tourniquet used in issue military tourniquet used in first aid in 2015. The
first aid in 2015, and the current model is called Genera- C-A-T is in its sixth version, called Generation 6, as there
tion 6. Soldiers in the field, however, have been asking for have been five sets of refinements in its design over the
design changes in a possible Generation 7 to improve ease past decade. C-A-T Generation 6 (C-A-T 6) has been
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of use. This study compared the differential performance bought worldwide over the past several years. However,
in use of the C-A-T in two designs: Generation 6 (C-A-T Servicemembers in the field have been asking for design
6) versus a prototype Generation 7 (C-A-T 7). Methods: changes in the current Generation 6 to improve ease of
A laboratory experiment was designed to test the perfor- use in a possible Generation 7 version (C-A-T 7). The
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mance of two tourniquet designs in hemorrhage control, purpose of the present study was to compare the differ-
ease of use, and user preference. Ten users of the two ential performance in use of the C-A-T in two designs:
C-A-T models placed them on a manikin thigh to stop C-A-T 6 versus a prototype C-A-T 7 (Figures 1 and 2).
simulated bleeding. Users included trauma researchers
and instructors of US Army student medics. Ten users con- Methods
ducted 20 tests (10 each of both designs). Results: Most re-
sults were not statistically significant in their difference by This study was conducted under a protocol for a lab-
C-A-T design. The mean difference in blood loss was sta- oratory experiment designed to compare the function
tistically significant (p = .03) in that the C-A-T 7 performed of tourniquets and was reviewed and approved by the
better than the C-A-T 6, but only in the mixed statistical Regulatory Compliance Division of the US Army Insti-
model analysis of variance, which accounted for user ef- tute of Surgical Research. The experiment was designed
fects. The difference in ease-of-use score was statistically to test the performance of two tourniquet designs in
significant (p = .002); the C-A-T 7 was easier. All users
preferred the C-A-T 7. Conclusion: In each measure, the Figure 1 Combat Application Tourniquet Generation 6 is a
C-A-T Generation 7 prototype performed similar or better US military, standard-issue tourniquet. Photograph is used
with permission of North American Rescue Products.
than Generation 6, was easier to use, and was preferred.
Keywords: first aid; damage control; hemorrhage; shock;
tourniquet; resuscitation

Introduction
Tourniquet use in first aid has become a public health
policy of the United States. At the White House on 6 Oc-
tober 2015, the Administration launched a plan to pro-
vide bystanders of emergency situations with the tools
and knowledge to stop life-threatening bleeding for all
Americans, in a campaign called “Stop the Bleed.”
1–7
The Combat Application Tourniquet (C-A-T; Composite
®

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