Page 65 - Journal of Special Operations Medicine - Spring 2016

In the future, with larger samples of students available, The JETT is applied more quickly than the CRoC. The
analysis of evaluation and performance could be made JETT is more effective in not slipping on tightening or in
according to military and/or medical background. use than the CRoC. The JETT is easier to reapply than
the CRoC. Only the JETT received positive evaluation,
The questionnaire we used was initially designed to on average, on these last three particular parameters.
obtain students’ evaluations on four junctional tourni- The JETT is more lightweight than the CRoC.
quets. However, because of the curriculum of the SOF
AMFR course, the students focused on, evaluated, and Although the results indicated the JETT is more satisfac-
tested only the CRoC and the JETT. tory in general terms; more effective in stopping bleeding
from junctional areas such as the groin, pelvis, buttock,
The 75 analyzed questionnaires were obtained from at- shoulder, or neck; easier in releasing compression; safer
tendees of seven SOF AMFR courses during February to use; and smaller in profile than the CRoC, they were
2014 to November 2015, whereas objective data (time not statistically significant.
measurement) were obtained from 33 attendees of two
of those SOF AMFR courses, when ideal weather condi- Considering all different aspects together, the JETT is an
tions were present (i.e., 17°C–22°C, no rain or snow). overall better device than the CRoC.

The JETT is capable of occluding unilateral or bilateral The results from the time measurement indicated the
common femoral artery blood flow to the lower extrem- JETT was applied more quickly than the CRoC by
ities, whereas the CRoC is capable of exerting mechani- approximately 15 seconds on average (p < .001). The
cal pressure directly over the wound area or indirectly fastest CRoC and JETT applications were 37 and 29
over the groin area to occlude underlying blood vessels, seconds, respectively.
and has also been cleared by the US Food and Drug Ad-
ministration for control of axillary hemorrhage. Both Three of 33 students did not effectively eliminate the
5
devices can be used to occlude a common femoral artery distal pulse with the JETT, whereas all effectively did
and, therefore, for the two devices’ application times to so with the CRoC. There was a 9% failure rate of the
be examined in our survey, unilateral groin applications JETT occluding a unilateral common femoral artery.
were used. It was noticed that the failure of these three students
was due to insufficient tightening of the pelvic binder
The statistical analysis of students’ evaluations of both of the JETT before increasing exerted pressure with the
devices suggests that the strongest aspects of the CRoC threaded T-handled pad. Thus, it can be concluded that
are related to its capability to stop bleeding effectively the JETT was not easier to use than the CRoC. It also
from junctional areas, to compress bleeding from sites required more training or familiarization for proficiency
where regular tourniquets cannot be applied and to its than did the CRoC, and it was not more effective than
safety during application; and that the weakest aspects the CRoC in tactical situations. These statements refute
of the CRoC are related to its capability to be quickly the subjective evaluations of the students voting in favor
applied and to be considered essential to carry in a first of JETT on the respective categories.
responder’s medical bag. The analysis suggests the stron-
gest aspects of the JETT are related to its capability to Even though the simulated bleeding was not primar-
compress bleeding from sites where regular tourniquets ily controlled with the JETT by three students, they
cannot be applied and to its safety during application, restarted their JETT application and eventually suc-
and its weakest aspects are related to its capability to ceeded in eliminating the distal pulse. It was noticed
not slip on tightening or in use and to be considered es- that the prolonged unthreading and rethreading of the
sential to carry in a first responder’s medical bag. T- handled pad considerably increased the reapplication
time of the JETT. Two of these three students needed
The JETT is more desirable as a first responder’s medi- more than three times the average effective JETT appli-
cal bag tool than the CRoC. However, neither device cation time and approximately twice the slowest JETT
received positive evaluation, on average, on that partic- effective application time. Therefore, the JETT’s ability
ular aspect. The JETT is more effective in compressing to be reapplied easily is questioned, especially consider-
bleeding from sites where regular tourniquets cannot be ing the high scores the tool received on the question-
applied than the CRoC. The JETT is more effective in naire with respect to that particular question.
prehospital care on the battlefield and in tactical situa-
tions than the CRoC. Only the JETT received positive It was also noticed that the most time-consuming part
evaluation, on average, on that particular parameter. of the CRoC application was its assembly. Therefore,
The analysis indicated the JETT is easier to use and re- the CRoC’s application time could be drastically re-
quires less training or familiarization than the CRoC. duced if the device is kept assembled and firm pressure

SOF Testing of CRoC and JETT Tourniquets 49