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
