Page 90 - JSOM Summer 2020

FIGURE 3 Phase 3: Secured strap pressures.

(A) (B)

(C) (D)

On each panel, the y-axis has the same scale and shows pressure exerted with the strap secured over different clothing conditions on thighs.
Dotted lines at 150mmHg indicate the desired secured pressure threshold. 4,12-14 Panel A shows individual triplicate values with group medians
and interquartile ranges, while panels B–D show individual triplicate values as medians with bars indicating the minimum and maximum values.
In B–D, applier single arm pull strength is shown above the x-axis. (A) Secured pressures achieved when standing (Phase 3) versus kneeling
(Phase 2) (n = 13 appliers, paired t test with Bonferroni correction: C-A-T7 p = .0014, SOFTTW p = .7372, Tac RMT p < .0001). (B) Phase 3
C-A-T7. (C) Phase 3 SOFTTW. (D) Phase 3 Tac RMT.

All applications with nonelastic tourniquets reached secured Clothing and bladder conditions were not associated with
(Figure 4A–4C); most reached occlusion; reaching completion higher or lower occlusion or completion pressures. C-A-T7 oc-
varied among tourniquets (Figure 4A–4D). Completion was clusion pressures were the highest (Figure 5A). Figures 5B–5D
least frequent with windlass tourniquets: recipient discomfort show C-A-T7 pressure changes from occlusion to completion
was the primary reason for C-A-T7 noncompletions. Recip- are higher than SOFTTW (p < .0001). C-A-T7 had four pres-
ient discomfort and applier inability to secure the windlass sure losses (median 6.3mmHg, 1.9 to 29.1mmHg) and one
rod were the primary reasons for SOFTTW noncompletion, occlusion loss within 5 seconds of completion. SOFTTW had
followed by applier inability to turn the windlass rod to a 26 pressure losses (median 22.4mmHg, 1.4 to 65.7mmHg)
securable location. Applier technique issues caused non- and 24 occlusion losses. Tac RMT had consistent pressure
completions: hook-and-loop error resulted in one C-A-T7 increases (one pressure loss of 5.6mmHg) and no occlusion
noncompletion, technique problems lead to ten SWATT losses. SWATT had 46 pressure losses (median 18.2mmHg,
noncompletions. 1.4 to 59.7mmHg) and eight occlusion losses (one tuck failed

88 | JSOM Volume 20, Edition 2 / Summer 2020