Page 54 - JSOM Fall 2020

OMNA Marine Tourniquet Self-Application

Emma Hingtgen, BS ; Piper Wall, DVM, PhD *; Charisse Buising, PhD 3
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ABSTRACT
Background: The OMNA Marine Tourniquet is a 5.1cm-wide, Methods
simple redirect buckle, hoop-and-loop secured, ratcheting
tourniquet designed for storage and use in marine environ- The Drake University Institutional Review Board approved
ments. This study evaluated self-application effectiveness and this prospective study, which took place October 2019 through
®
pressures. Methods: Triplicate secured, occlusion, and comple- March 2020. The OMNA Marine Tourniquets (Generation
tion pressures were measured during 60 subjects pulling down 2, Lot UDI: + B123 OMTOMNA005A) were donated by
or up thigh applications and nondominant, single-handed arm OMNA, Inc.
applications. Arm pressure measurements required circumfer-
ences ≥30cm. Results: Thirty-one subjects had arm circumfer- Tourniquet
ences ≥30cm. All 540 applications were effective; 376 of 453
applications had known secured pressures >150mmHg (89 of OMNA Marine Tourniquets (Figure 1 and video reference 10)
93 arm). Thigh down versus up pulling directions were not are nonelastic, 95cm-long, and have a 5.1cm-wide hook-and-
different (secured, occlusion, and completion pressures and loop strap; non-self-securing, round, simple redirect buckle;
ladder tooth advances). Occlusion pressures were 348mmHg and self-securing ratcheting buckle on a toothed ladder tight-
(275–521mmHg) for combined thighs and 285mmHg (211– ening system. The redirect buckle is attached to a 6.9cm-wide
372mmHg) for arms. Completion pressures were 414mmHg by 9.0cm-long section that is neoprene-backed (or neo-
(320–588mmHg) for combined thighs and 344mmHg (261– prene-like material) and contains a sleeve through which the
404mmHg) for arms. Correlations between secured pressures toothed ladder passes to attach to the hook-and-loop strap. A
and occlusion ladder tooth advances (clicks) were r = 0.44 hook-and-loop bite strap is located over the redirect buckle.
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for combined thighs and 0.68 for arms. Correlations between
occlusion pressures and occlusion clicks were poor (r = 0.24, Tourniquet Subjects
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P < .0001 for combined thighs and r = 0.027, P = .38 for Sixty volunteers met inclusion criteria: age ≥18 years; systolic
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arms). Conclusions: The OMNA Marine Tourniquet can be blood pressure <140mmHg; no known bleeding or clotting ab-
self- applied effectively, including one-handed applications. normalities, circulation problems, pain syndromes, peripheral
Occlusion and completion pressures are similar to reported neuropathies, connective tissue disorders, conditions counter
3.8cm-wide Ratcheting Medical Tourniquet pressures. to the positioning required for thigh or arm use; and no
known conditions that would be counter to tourniquet appli-
cation (e.g., hand, wrist, elbow, or shoulder injuries). Subjects
Keywords: tourniquet; hemorrhage; first aid; emergency had example videos to watch, 11-13 had blood pressure mea-
treatment
sured, did a single-arm pull of 13.6kg (30 pounds) or greater,
practiced with real-time pressure feedback, and demonstrated
proficiency prior to data collection. Subjects wore shorts and
Introduction
t-shirts; disclosed age, height, weight, dominant arm, and sex;
Serious limb injuries occur in marine environments from surf- had mid-thigh and mid-arm circumferences measured and
board and surfboard fin impacts, spearfishing accidents, shark marked; and had applications videoed.
attacks, oil rig and ship machinery mishaps, interactions with
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watercraft propellers, collisions, and storms. The moisture Subject Pulling Force
and salinity of marine environments can have adverse impacts To determine single-arm downward pulling force, increasing
on emergency-use-limb tourniquet materials, especially metal weight increments of 4.54kg were attached to a C-A-T7 strap,
components. The OMNA Marine Tourniquet (OMNA, which was placed over a smooth metal rod (1.2cm- diameter). 14
®
www.omnainc.com) is designed for storage and use in marine Seated subjects pulled down on the free end of the strap with
environments. encouragement to engage their entire upper body strength and
weight.
The study purpose was to evaluate OMNA Marine Tourni-
quet self-application effectiveness and pressures. The hypothe- Pressure Measurements
ses were that subjects would be able to occlude thigh and arm Pressures were measured using a No.1 neonatal blood pres-
arterial flow with OMNA Marine Tourniquet self-application. sure cuff (2.2cm × 6.5cm bladder, single tube) at 18mmHg
*Correspondence to piperwall@q.com
1 Ms Hingtgen is a researcher at Drake University, Des Moines, IA. Dr Wall is a researcher in the Surgery Education Department, UnityPoint
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Health Iowa Methodist Medical Center, Des Moines, IA. Dr Buising is a professor of biology and the director of the Biochemistry, Cell and
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Molecular Biology Program, Drake University, Des Moines, IA.
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