Page 46 - JSOM Winter 2019

TABLE 76 SWAT-T Simplicity of Application TABLE 78 SWAT-T Specifications
Total Part
Score Score Score Ease of Use n = Citation Score Score
75% Rated as Easy / 25%
4 Rated as Challenging to apply 16 14
to calf.
88% Rated as Easy / 12%
4 Rated as Challenging to apply 16 14
to forearm.
The SWAT were the most
difficult for the volunteers to
apply and tended to require
1 40 27
multiple adjustments and
reapplications to achieve
occlusion.
2.33 Applications were rated Easy
2 (101/67%), Challenging 150 63
(37/25%), Difficult (12/8%).
Reported 16 instances in
which the volunteer had
to reapply the tourniquet
1 to achieve occlusion, 48 27
6.73
contributing to longer
application times.
If occlusion was obtained,
securing the tourniquet was
2 20 31
very difficult and would come
unsecured with little effort.
Part
Score Score Steps to Complete n = Citation
4 One-Handed – 7 Steps. n/a 64
5 Two-Handed – 4 Steps. n/a 64
Median 5.25 wraps
(minimum 3.5 – 6.5
4 maximum) on calf 16 14
4.40
application.
Median 6 wraps (minimum
4 4.5 – 7.5 maximum) on 16 14
forearm application.
5 4.50 wraps (mean). 20 31
TABLE 77 SWAT-T Pressures
Total
Score Score Pressures n = Citation Total
258mmHg mean combined
5 199 combined
pressures of all studies.
190mmHg mean – tended to
require slightly less pressure to
5 48 27
achieve occlusion on the HapMed
Leg Tourniquet Trainer.
Calf application pressures at
occlusion, completion, and 120
4.60 4 seconds after completion 212 ± 46, 16 14 (SOFTT) – SCORE: 34.17.
294 ± 59, 287 ± 57mmHg
Forearm application (n = 15)
pressures at occlusion, completion,
4 and 120 seconds after completion 16 14 data, it was recommended that the original SOFTT be re-
181 ± 34, 308 ± 70, 302 ±
70mmHg
Occlusion completion pressure
5 61 35
mean 290mmHg (136–449)
44 | JSOM Volume 19, Edition 4 / Winter 2019
Total
Specifications Scoring
Width – ≥1.5 inches 1 – Yes /
1 (critical requirement). 3.95 inches –1 – No
Length – ≥37.50 inches
1 or provide 35 inches 54.40 inches 1 – Yes /
circumferential (critical –1 – No
requirement).
3 0 Locking Mechanism/ No 1 – Yes /
Method. 0 – No
1 – Yes /
0 Time Recording. No 0 – No
1 Weight – <8 ounces (critical 3.79 oz 1 – Yes /
for JFAK inclusion). –1 – No
TABLE 79 SWAT-T Complications and Safety
Total
Score Score Complications and Safety n = Citation
Occlusion pressure decrease over
1 minute after occlusion of 6mmHg
4 61 35
(± 8) with 5 of 61 applications
requiring adjustment.
SWAT had a combination of
breakages, including two critical
3.0
failures where the device material
ripped during application. The
2 physical requirement for application 48 27
was difficult for several of the
volunteers and made applying and
securing the device unobtainable.
TABLE 80 SWAT-T Usage
Total
Score Score Usage Citation
No combat usage documented in medical
2 literature. n/a
No civilian usage documented in medical
1.33 2 literature. n/a
No user preferences documented in
0 n/a
medical literature.
TABLE 81 SWAT-T Logistics
Score Score Logistics
0 NSN in DoD System. NONE
3.33 5 GSA Cost per Unit. $11.52
5 Commercial Cost per Unit. $17.95
Special Operations Forces Tactical Tourniquet
The original SOFTT is a windlass (metal) tourniquet with a
strap and single-routed gripping buckle. Based on reviewed
moved from the CoTCCC-recommended tourniquets list. In
contrast, the SOFTT-Wide is CoTCCC-recommended and
based on available data seems to be the device predominantly
fielded since circa 2012. Only two studies in 2015 by Hel-
30
25
denberg et al. and in 2013 by Savage et al. involved the
SOFTT whereas all others were circa 2005 to 2007. Compres-
sion pressure data were scored only 1 point as there was no
pressure data on the SOFTT found in the medical literature.
Further, the SOFTT is only 1 inch wide which does not meet
the 1.5 inches minimum width requirements established by
the tourniquet working group and previous consensus. 6,7,65,66