Page 18 - JSOM Summer 2020

2015;15(4):21–26 ABSTRACT Conclusion: All three tactical tourniquets showed
substantial capacity for hemorrhage control. However, the
Testing Tourniquet Use in a Manikin Model: Two Improvised two new tourniquet models (RATS and TMT) did not offer
Techniques Lyles WE, Kragh JF Jr, Aden JK 3rd, et al.
any improvement over the C-A-T, which is currently issued to
ABSTRACT Conclusion: In the present experiment, the military services. Indeed, one of the new models, the RATS,
commercial CAT performed better than either improvised was inferior to the C-A-T in terms of speed of application and
tourniquet. simulated loss of blood. Opportunities were detected for re-
finements in design of the two new tourniquets that may offer
2015;15(4):28–38 future improvements in their performance.
Different Width and Tightening System: Emergency Tourni-
quets on Distal Limb Segments Wall PL, Sahr SM, Buising CM 2016;16(1):36–42
Testing of Junctional Tourniquets by Medics of the Israeli De-
ABSTRACT Conclusions: All four designs can be effective
on distal limb segments, the SWATT doing so with the low- fense Force in Control of Simulated Groin Hemorrhage Chen
est pressures and least pressure losses over time. The pressure J, Benov A, Nadler R, et al.
change from Occlusion to Completion varies by tourniquet ABSTRACT Conclusion: In the five assessment categories,
tightening system and can involve a pressure decrease with the multiple tourniquet models performed similarly well; SJT
windlass tightening systems. Pressure losses occur in as little and AAJT performed best in four categories, JETT was best
as 120 seconds following Completion and so can loss of Oc- in three, and CRoC was best in two. Differences between
clusion. This is especially true for nonelastic strap tourniquet the top-ranked models in each category were not statistically
designs. significant.

2016;16(1):14–17 2016;16(1):44–50
Short Report Comparing Generation 6 Versus Prototype Gen- Evaluation and Testing of Junctional Tourniquets by Special
eration 7 Combat Application Tourniquet in a Manikin Hem- Operation Forces Personnel: A Comparison of the Combat
®
orrhage Model Kragh JF Jr, Moore VK 3rd, Aden JK 3rd, et al. Ready Clamp and the Junctional Emergency Treatment Tool
Theodoridis CA, Kafka KE, Perez AM, et al.
ABSTRACT Conclusion: In each measure, the C-A-T Genera-
tion 7 prototype performed similar or better than Generation ABSTRACT Conclusion: Even though the JETT might be pre-
6, was easier to use, and was preferred. ferred by military medical providers, the CRoC still has merits.
As both devices proved to occlude the arterial flow in no less
2016;16(1):19–28 than 54 seconds on average, they could be used to supplement
direct pressure and wound packing, the latter two still being
Management of External Hemorrhage in Tactical Combat Ca- considered the immediate actions for inguinal bleeding con-
™
sualty Care: The Adjunctive Use of XStat Compressed He- trol. Considering that the CRoC and the JETT can be applied
mostatic Sponges: TCCC Guidelines Change 15-03 Sims K, in as little as 37 and 29 seconds, respectively, users should be
Montgomery HR, Dituro P, et al.
effectively trained and entirely proficient on either device to
ABSTRACT Exsanguination from wounds in the so-called justify their election as the primary countermeasure to hemor-
junctional regions of the body (i.e., the neck, the axilla, and rhage not amenable to regular tourniquets.
the groin) was responsible for 19% of the combat fatalities
who died from potentially survivable wounds sustained in 2016;16(2):13–15
Afghanistan or Iraq during 2001 to 2011. The development
of improved techniques and technology to manage junctional Preliminary Measures of Instructor Learning in Teaching Junc-
hemorrhage has been identified in the past as a high-prior- tional Tourniquet Users Kragh JF Jr, Aden JK 3rd, Shackel-
ity item by the Committee on Tactical Combat Casualty Care ford S, et al.
(CoTCCC) and the Army Surgeon General’s Dismounted ABSTRACT Conclusions: The instructor›s teaching experi-
Complex Blast Injury (DCBI) Task Force. Additionally, pre- ence appeared to directly affect user performance; in a model
hospital care providers have had limited options with which to of junctional hemorrhage, the volume of blood loss from the
manage hemorrhage resulting from deep, narrow-track, pen- manikin during junctional tourniquet placement was a useful
etrating trauma. XStat™ is a new product recently approved metric of instructor learning. The CUSUM technique detected
by the US Food and Drug Administration as a hemostatic ad- a small but meaningful change in trend where the instructor
junct to aid in the control of bleeding from junctional wounds learning curve was greatest while working with the first seven
in the groin or axilla. XStat has now been recommended by users.
the CoTCCC as another tool for the combat medical provider
to use in the management of junctional hemorrhage. The evi- 2016;16(2):17–19
dence that supports adding XStat to the TCCC Guidelines for
the treatment of external hemorrhage is summarized in this Tourniquet Effectiveness When Placed Over the Joint Service
paper. Lightweight Integrated Suit Technology Peponis T, Ramly E,
Roth KA, et al.
2016;16(1):29–35 ABSTRACT Conclusion: The C-A-T effectively occludes ar-
terial flow in the lower extremity, even when applied over the
Preliminary Comparison of New and Established Tactical Tour- JSLIST. This finding supports existing military doctrine for
niquets in a Manikin Hemorrhage Model Gibson R, Housler tourniquet application over the JSLIST in the nonpermissive
GJ, Rush SC, et al.
CBRN environment to control extremity exsanguination.

16 | JSOM Volume 20, Edition 2 / Summer 2020