Page 133 - JSOM Summer 2019

FIGURE 5 FIGURE 7
Placement of SOFTT-W with
windlass in relation tightly rolled SAM
to apex of PDD. Splint.

litter. It is for this reason that pushing the slack out across the tension, pressure, and torque required for success. The
the patient’s body makes for less complicated application question of “exactly how much torque is required?” can be
(Figure 6). answered by training the task to the point that the rescuer
9. Junctional tourniquets move during transport. No junc- repeatedly demonstrates the ability to eliminate distal pulses
6
tional tourniquet, whether commercial or improvised, (Figures 8–10).
travels well. Junctional tourniquet placement must be con-
firmed by visual inspection and distal pulselessness, at reg-
ular intervals and after any movement.

FIGURE 6 Taking out all the tourniquet slack prior to turning the FIGURE 8 Two
windlass. Failure to perform this step is the number one reason for cravats square
tourniquet failure. knotted onto the
casualty. One
around the waist,
the other around
the thigh on the
injured side.

FIGURE 9 Slide water
bottle or selected PDD
under both cravats. The
PDD will naturally come
to rest in the inguinal
gutter slide windlass
between the PDD and the
cravats. The axis of the
Examples of Improvised Junctional Tourniquets spinning windlass should
be just medial of the apex
SOF Tactical Tourniquet-Wide (SOFTT-W) tourniquet and of the PDD.
tightly rolled SAM splint (or other suitable PDD): Medics
throughout SOF are intimately familiar with both items. At
41 inches (104 cm), the SOFTT-W is typically long enough
to be wrapped around the waist, making it an obvious choice
over other options. The SOFFT-W is preferred due to its wider
profile that provides additional stability. At 37.5 inches (95 FIGURE 10 Turn
®
cm), Combat Application Tourniquets (C-A-T) tend to be too the windlass until
short to wrap around the average adult waist by themselves distal pulse has
and therefore must be doubled up in most cases if used in place been eliminated
and secure the
of the SOFFT-W (Figure 7). windlass with the
tails from the two
Two cravats, water bottle, and trauma shears: Of all the ex- cravats.
amples shown, this one is the most versatile. Other items can
replace every suggested object in this IJT if they can withstand

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