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how human use aspects of the CAT and ST impact the field 8. Shackelford SA, Butler FK Jr, Kragh JF Jr, et al. Optimizing
performance of both tourniquets when used by a larger and the use of limb tourniquets in Tactical Combat Casualty Care:
more diverse cohort of users may yield critical insights about TCCC guidelines change 1402. J Spec Oper Med. Spring 2015;
the generalizability this study’s findings. 15(1):17–31.
9. Jacobs LM. The Hartford Consensus IV: a call for increased na
tional resilience. Bull Am Coll Surg. Mar 2016;101(3):17–24.
Conclusion 10. Butler FK. Two decades of saving lives on the battlefield: Tacti
cal Combat Casualty Care turns 20. Mil Med. Mar 2017;182(3):
In this study, the adhesive wrap–based ST delivered hemorrhage e1563–e1568.
control at high success rates, rapid application and occlusion 11. Kragh JF Jr, Littrel ML, Jones JA, et al. Battle casualty survival
times, and with easeofuse scores similar to the windlassbased with emergency tourniquet use to stop limb bleeding. J Emerg
CAT, yet at 40% lower completion pressures thus significantly Med. Dec 2011;41(6):590–597.
reducing a leading risk factor for tourniquetassociated limb 12. Tarpey MJ. Tactical combat casualty care in Operation Iraqi
Freedom. US Army Med Dep J. 2005:38–41.
injury. This finding warrants further investigation as it suggests 13. Montgomery HR, Hammesfahr R, Fisher AD, et al. 2019 recom
that minimally elastic, wraptightened designs may be a safer mended limb tourniquets in Tactical Combat Casualty Care. J
alternative to windlasstightened tourniquets. Spec Oper Med. Winter 2019;19(4):27–50.
14. Heldenberg E, Aharony S, Wolf T, et al. Evaluating new types of
tourniquets by the Israeli Naval special warfare unit. Disaster Mil
Acknowledgments Med. 2015;1:1.
Statistical analysis support was provided by Mr Nima S. Hejazi 15. Wall PL, Sahr SM, Buising CM. Different width and tightening
who was financially compensated by Entrotech Life Sciences system: Emergency tourniquets on distal limb segments. J Spec
Inc. for this assistance. Cadaver access and preparation, as well Oper Med. Winter 2015;15(4):28–38.
as technical laboratory support, were provided by personnel 16. Slaven SE, Wall PL, Rinker JH, et al. Initial tourniquet pressure
from Wake Forest School of Medicine which was financially does not affect tourniquet arterial occlusion pressure. J Spec Oper
compensated by Entrotech Life Sciences Inc. for this service. Med. Spring 2015;15(1):39–49.
17. Kragh JF Jr, Newton NJ, Tan AR, et al. New and established
models of limb tourniquet compared in simulated first aid. J Spec
Funding Oper Med. Summer 2018;18(2):36–41.
This project was funded by Entrotech Life Sciences Inc. which 18. Lakstein D, Blumenfeld A, Sokolov T, et al. Tourniquets for hem
designed and owns the SoloT. The Combat Application Tour orrhage control on the battlefield: a 4year accumulated experi
niquets used in this study were purchased by Entrotech Life ence. J Trauma. May 2003;54(5 Suppl):S221–S225.
Sciences Inc. 19. Wall PL, Welander JD, Singh A, et al. Stretch and wrap style tour
niquet effectiveness with minimal training. Mil Med. Nov 2012;
177(11):1366–1373.
Financial Disclosures 20. Glick C, Furer M, Glassberg C, et al. Comparison of two tourni
GJH, SVH, and JEM are employees of Entrotech Life Sciences quets on a midthigh model: the Israeli silicone stretch and wrap
Inc. JSF is a financially compensated consultant of Entrotech tourniquet vs. the Combat Application Tourniquet. Mil Med.
Life Sciences Inc. Mar 1 2018;183(suppl_1):157–161.
21. Kragh JF Jr, Murphy C, Steinbaugh J, et al. Prehospital emer
gency inguinal clamp controls hemorrhage in cadaver model. Mil
Author Contributions Med. 2013;178(7):799–805.
All authors conceived of the study concept. JEM obtained 22. Johnson JE, Sims RK, Hamilton DJ, et al. Safety and effective
funding. JSF oversaw the study. GJH, JSF, and SVH partici ness evidence of SAM(r) junctional tourniquet to control inguinal
pated in the study and collected data. GJH designed, coordi hemorrhage in a perfused cadaver model. J Spec Oper Med. Sum
nated, and managed the study, analyzed results, and wrote the mer 2014;14(2):21–25.
manuscript. All authors approved the final manuscript. 23. Gates KS, Baer L, Holcomb JB. Prehospital emergency care:
evaluation of the junctional emergency tourniquet tool with a
perfused cadaver model. J Spec Oper Med. Spring 2014;14(1):
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54 | JSOM Volume 22, Edition 3 / Fall 2022
