Page 49 - JSOM Winter 2019

FIGURE 16 Rapid Application Tourniquet System. Tourniquets with total scores <20.00.
The McMillan Tourniquet, NATO Tourniquet, Ramsey’s Red-
Pull Tourniquet, London Bridge Ratchet Tourniquet (LBRT),
and the USGI Self-Applied Tourniquet System (SATS) scored
less than 20 out of 50 points in this tourniquet review pri-
marily resulting from poor performance in studies and lack
of data.

• The McMillan Tourniquet arterial occlusion efficacy
was reported with only 25% on leg applications and
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27.2% on arm applications and does not meet the
minimum width requirement of 1.5 inches.
• The NATO Tourniquet arterial occlusion efficacy was
reported with only 8.3% on leg applications and 21.7%
on arm applications. 67
• Ramsey’s Red-Pull Tourniquet was reported to have
failed to achieve occlusion in 90% of tests and was elim-
inated from future testing. 31
• The London Bridge Ratchet Tourniquet has a width of
1 inch and weight of 9.17 ounces and does not meet the
https://ratsmedical.com/collections/products/products/rats-gen-2-black
basic specifications of a military tourniquet. The LBRT
has a single reported combat usage in which hemorrhage
was controlled but the casualty had severe tourniquet
TK4 / Tourni-Quik / TK4L – SCORE: 21.17.
pain resulting from extreme compression pressures. 6
The TK4/Tourni-Quik/TK4L is a 2-inch band applied with cir-
cumferential stretching and wrapping around limb with hooks Based on available data, these tourniquets were not included
for pulling tension and securing to achieve occlusion. Only in the current CoTCCC-recommended tourniquets list.
one study found in medical literature reports occlusion and
application times and there was no data found on occlusion
pressures. Arterial occlusion is reported as 80% on arm appli- Tourniquets without published data at this time.
cations and 54.1% on leg applications and mean application Recon Medical Tourniquet – The Recon Medical Tourniquet
times of 72.8 seconds (± 33.9) for the arm and 65.3 seconds is a Windlass (aluminum) tourniquet using Velcro adhesion
(± 32.5) for leg applications. The TK4 was dropped from to strap with single routed buckle and finger-hole for pulling
67
a previous study as it broke on initial application and safety tight. There was no study performance data found in medi-
31
concerns prevented further testing. The instructions for the cal literature on the RECON Tourniquet. The RECON Tour-
TK4 specifically mention “DO NOT let go of the strap while niquet meets the basic specifications required and functions
winding; this will result in the hook and strap unraveling and along the same principles as the CAT and TMT. The RECON
64
may cause injury.” The USMC fielded the TK4 for a period, Tourniquet certainly warrants further review and consider-
but it was replaced with the CAT in 2009. Based on available ation for military application when more data is available.
data, the TK4/Tourni-Quik/TK4-L was not included in the
current CoTCCC-recommended tourniquets list.
FIGURE 18 RECON tourniquet.

FIGURE 17 TK4 / TK4L.

https://www.rescue-essentials.com/tourni-kwik-4-tk4-compression
-strap/

https://www.reconmedical.com/tourniquets/recon-medical
-tourniquet-gen-4-black/

Recommended Limb Tourniquets in TCCC | 47