Page 36 - Journal of Special Operations Medicine - Summer 2016

Data were gathered from February to August 2014. cover is snapped into the receiving hook and excess
The three pneumatic tourniquet models tested were the slack in the outer cover is pulled and secured down onto
Emergency and Military Tourniquet (EMT; Delfi Medi- itself upon its surfaces of self-adhering hooks and loops.
cal Innovations, http://www.delfimedical.com) and two The tourniquet is then inflated by squeezing the infla-
Tactical Pneumatic Tourniquet (TPT) models differing tion bulb repeatedly. Opening the pressure valve deflates
in width: 2 in. (50.8mm; TPT2) and 3 in. (76.2mm; the bladder. At the time of assessment, the TPTs were
TPT3) (Alphapointe, https://www.alphapointe.org). not registered with the FDA (Figure 2).

The EMT is a commercially developed field tourniquet. Figure 2 Tactical Pneumatic Tourniquet.
It consists of a heat-sealed, black nylon, inflatable blad-
der; a clamp; and a hand bulb inflator permanently at-
tached via a flexible hose (Figure 1). The EMT bladder
lies flat and is 88mm wide. The bladder is placed around
the limb as a circumferential loop, and the running end
of the strap is passed through the narrow opening be-
tween the two handles of the hinged clamp. The end of Photograph by J. Kragh
the bladder is then pulled firmly to remove slack from
the loop and to make the bladder snug to the limb. To The investigators used two models, one 2-in. wide and the other, 3-in.
increase snugness before closing the clamp, the end of wide.
the bladder can be pulled at an angle toward the D-
shaped handle of the clamp. By squeezing the handles of For comparison with the models of the study group, the
the clamp, the opening is closed securely down upon the Combat Application Tourniquet (C-A-T) Generation 6
bladder, which is then closed underneath. The bladder (Composite Resources, http://combattourniquet.com),
around the limb is inflated by squeezing the hand bulb of a commonly used strap-and-windlass design and
repeatedly; the inflatable portion inside the bladder is which is standard issue to the military forces of mul-
76mm wide while the overall width is 88mm, including tiple nations, served as the control tourniquet. The C-
the edges. The user deflates the bladder by twisting the A-T has a buckle that permits slack removal from the
air release valve to the open position; the valve is on the strap before turning of the windlass. The C-A-T strap is
tube between the inflator and bladder. At the time of 39mm wide. At the time of assessment, the C-A-T had
assessment, the EMT had been registered for years with been registered for years with the FDA (Figure 3).
the US Food and Drug Administration (FDA).
Figure 3 Combat Application Tourniquet.
Figure 1 Emergency and Military Tourniquet.

This image used with the permission of Delfi Medical Innovations,
http://www.delfimedical.com.
The TPT is a new, militarily developed field tourniquet. The Combat Application Tourniquet, with its strap-and-windlass de-
It consists of inner and outer covers, a pin holding the sign, served as the control model. It is standard issue to US military
covers together, a slider that snaps into a receiving hook, forces. This image used with the permission of Composite Resources,
and the inflation bulb. The inner cover is looped around http://combattourniquet.com.
the limb circumferentially and tightly; the inner cover There were two tourniquet users—a female undergrad-
includes the bladder. Then the pin is removed, allowing uate student and a male clinician-scientist. Both users
the outer cover to drop freely. The slider on the outer had familiarization training in use of the manikin. The

22 Journal of Special Operations Medicine Volume 16, Edition 2/Summer 2016