Optimal Tourniquet Engineering Features - Major Incidents - @ JEMS.com


Optimal Tourniquet Engineering Features

 

 
 
 

Jeffrey S. Cain, MD | | Tuesday, September 30, 2008


 

1. Must Stop Arterial Bleeding in Lower Extremities

  • Must be 100% effective in clinical environment
  • Must account for large girth lower extremities (95% male soldier=26.7")


2. Optimal Design: Pneumatic Cuff
Note: USAISR and historical studies show pneumatic device superiority because of the manner in which they distribute force evenly over a wider area, making them suitable for surgical procedures. Only the Delphi EMT received recommendations by the USAISR due to its ability to be secured by a clamp; surgical tourniquets were considered too expensive.

Advantages:

  • Creates even pressure distribution over wider area
  • Pressure can be easily measured
  • Lower incidence of comorbidity; lower shear stress forces along edges


Disadvantages:

  • Difficult to ruggedize for austere environment (shelf life, puncture, leaks)
  • Larger/heavier
  • Expensive

 
3. Temporary Tactical Tourniquets

  • Width > 1"
  • Integrated mechanical augmentation (windlass, ratchet, cam)
  • Easily applied to upper or lower extremity (in less than one minute)
  • No external power requirement (batteries)
  • Light weight (< 230 g) and minimal cube space (facilitates individual carry)
  • Easy to train
  • Must not slip during application
  • Must have easy release and reapplication capability
  • Must prevent accidental release
  • Long shelf/storage life

 
4. Other Considerations

  • Can be applied to entrapped limbs
  • Can be self-applied with one hand
  • Protection from over-tightening
  • Expense

 




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Related Topics: Major Incidents, Mass Casualty Incidents, Special Operations, WMD and Terrorism

 

Jeffrey S. Cain, MDJeffrey S. Cain is an emergency medicine physician practicing in McKinney, Texas. He is a graduate of West Point and the Uniformed Services University of the Health Sciences, with service in the 75th Ranger Regiment as an infantry officer and later as a battalion physician.

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