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Dr. Jeffrey Cain | From the The War on Trauma Issue

FEATURED IN TRAINING

• Training for Active Shooter Response
• 2013 Trainer of the Year!
• Tips for Trainers
• 5 Reasons to Further Your Education
• Time for a Simulator?
• FBI Hostage Rescue Team Agents Killed in Training Exercise
• 10th-Anniversary Conference Shines Brighter than Ever

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