Page 36 - JSOM Fall 2021

FIGURE 5 Arm and thigh secured tourniquet pressures.

(A) (B)

(C) (D)

The y-axis shows the hands off, secured tourniquet pressure, and the x-axis shows which holding loop location. Self-applications are indicated
by circles. Buddy-applications are indicated by diamonds. NEAR is the standard, commercially available Tactical Ratcheting Medical Tourni-
quet (Tac RMT) with the holding loop near the strap redirect buckle. FAR is the modified Tac RMT with the holding loop at the other end of
the toothed ladder from the strap redirect buckle. (A) Arm, self-application secured pressures. (B) Arm, buddy-application secured pressures.
Buddy-applications of the FAR version used crossed hands to grasp the holding loop and free end of the strap and thumb assistance of the strap
into the redirect buckle (blue symbols). (C) Thigh, self- and buddy-application secured pressures. None of the applications included thumb
assistance of the strap into the redirect buckle. (D) Thigh, self- and buddy-application secured pressures. All FAR applications included thumb
assistance of the strap into the redirect buckle (blue symbols).

Regarding the arm self-applications, we chose to trap the tour- previous study involving strap-pulling techniques with model
5
niquet against the chest to prevent tourniquet rotation around setups and human applications, this study shows that emer-
the arm while pulling the strap. Because it allows the pulling gency-use limb tourniquet findings with model setups can fail
hand to move across the chest with a good angle of strap pull to translate to actual applications and therefore need to be
5
at the redirect buckle, we already knew that we preferred this checked with applications by humans to humans.
technique with the commercially available Tac RMT with the
NEAR holding loop. Use of the tourniquet trapping technique
in arm self-applications involves arm muscle use; relaxation of Conclusions
muscles under a tourniquet can lead to dramatic decreases in Moving the Tac RMT holding loop location from adjacent to
16
tourniquet pressure, so there is a drawback to this technique. the redirect buckle to the far end of the toothed ladder does not
appear advantageous for how human appliers pull the strap
This small proof-of-concept study had the obvious labora- tight when applying to live human limbs. This small proof-
tory setting limitations. Nevertheless, just as happened in a of-concept study shows how limb tourniquet design changes

34 | JSOM Volume 21, Edition 3 / Fall 2021