Page 94 - JSOM Summer 2020

FIGURE 6 Phase 3: Occlusion and completion data with tights.

(A) (B)

(C) (D)

On each panel, the x-axis is organized by applier. Panels show individual triplicate values as medians with bars indicating the minimum and
maximum values. All panels share the legend shown in panel A. Bare data is included for comparison with Tights Skin and Tights Clothing.
(A) Secured pressures are shown on the y-axis. Applier single arm pull strength is shown above the x-axis. (B) Occlusion and completion pressures
are shown on the y-axis. Recipient thigh circumference is shown above the x-axis. (C) Completion minus occlusion pressures are shown on the
y-axis. (D) Turns, clicks, or wraps to reach occlusion and completion are shown on the y-axis.

moving redirect comes into play despite the proximity of the rod turns. As turns increased, appliers became unable to con-
Tac RMT holding loop to the redirect buckle. tinue turning and unable to secure the rod in the triangle. Un-
like discomfort, which is unlikely to be relevant during clinical
Regarding differences in occlusion pressure, among the 3.8cm- tourniquet use, applier inability will be relevant.
wide tourniquets, the C-A-T7 had the highest occlusion pres-
sures by clinically significant amounts. This has implications Regarding applier technique, successful SWATT applications
for basing tourniquet certification on achieving a specified are more technique sensitive throughout the application pro-
pressure expected to be thigh occlusive for 95% of adults. cess than are nonelastic tourniquet applications. Small details
A different pressure value may be needed for each nonelastic matter and are easily overlooked. Despite watching a training
11
3.8cm-wide tourniquet. video complete with commentary, many appliers did the fol-
lowing: unrolled the SWATT “toward the thigh” rather than
Regarding design-related problems, successful Generation 3 “away from the thigh”; failed to maintain stretch passing the
SOFTTW applications were impeded by the redirect buckle: roll under the thigh; and immediately planned the comple-
low secured pressures resulted in a need for multiple windlass tion tuck at occlusion, regardless of the amount of SWATT

92 | JSOM Volume 20, Edition 2 / Summer 2020