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The Combat Application Tourniquet: Research, Characteristics, Use



CAT tourniquet

Research shows that 90% of American soldiers who died in combat after WWII did not receive timely first aid. 60% of preventable combat deaths were attributed to critical arterial bleeding.  As a result, the American Army began to look for a safe and effective tool that could be used by any soldier on the battlefield to reduce and possibly eliminate these figures.

* This article is for information purposes only, and should not replace proper tactical medicine training with a qualified instructor.


Research

In 2004, the United States Army Institute of Surgical Reseach tested ten (10) different tourniquets. 18 subjects were involved in testing the effectiveness of each tourniquet in accordance with IRB (Institutional Review Board) protocol. The criteria for determining the efficiency was based on the ability to stop arterial bleeding in the thigh. The subjects also evaluated the level of pain incurred by each tourniquet.

The study revealed that the CAT tourniquet was effective 100% of the time and was quick  to stop arterial bleeds in both upper and lower extremities. According to retired U.S. Army Ranger and senior medic Riccardo Flores, the CAT "induced the least amount of pain, was easiest to use and most effective." The Institute of Surgical Research confirmed its efficiency, and lightness - weighing half of similar products on the market. The amount of pain associated with this tourniquet was lower that the rest and was recommended for use to the United States Army.

Characteristics

The CAT tourniquet is unique in that it allows you to stop arterial bleeding without having to apply a great amount of pressure. The tourniquet band is made of a self-adhering Velcro, making it easy to apply to all extremities regardless of diameter.  The free end is pulled through the friction adaptor buckle, which provides maximum hold and can block snow and sand from getting in.  The windlass rod can be secured into the clip and easily loosened if need be.

CAT tourniquet

This design has several advantages over the rubber tourniquet. "Rubber tourniquets are not the best option, especially in low temperatures," says Vitaliy Kush, head of medical services of the operational command “Skhid”.  The CAT’s material is practical, even for use in cold weather. This tourniquet can be applied on bare skin, may be loosened if necessary, has a place to record the time of application and a visible red indicator on the end of the strap.

In 2004, the CAT was distributed to over one million soldiers in the US, Great Britain, Israel, and Canada.  Responsible for saving many lives on the battlefield, the tourniquet has played a key role in improving military medicine. For this reason, the Ukrainian military should adopt such tactical medicine standards so that soldiers are sent to combat with the proper tools to administer first aid.

The CAT tourniquet is optimal for controlling critical bleeding.  It is effective and can be quickly applied.
 

Instructions for Use

Source: The Combat Lifesaver Student Self-Study. The Army Institute for Professional Development. Edition B Subcourse IS0871

a. Two-handed application

CAT tourniquet application

1. Remove the Combat Application Tourniquet from the first aid kit

2. Wrap the self-adhering band around the wounded extremity.  Position it 5 cm above the wound.

3. Pass the tip of the band through the inside slit of the buckle and pull the band tight.

4.  Pass the tip of the band through the outside slit of the buckle.  The friction buckle will lock the band in place.

5.  Pull the band very tight and securely fasten the band back on itself.

When the tourniquet is properly applied and fixated, no more that three fingers should fit between the band and the limb.

6.  Twist the windlass rod with both hands so as to tighten the tourniquet.  Continue twisting until the bright red bleeding has stopped and the distal pulse is eliminated.

7.  Place the rod inside the clip; this locks the tourniquet in place.

8. Check to make sure that arterial bleeding has stopped and that the distal pulse is not present.

a) If bleeding is not controlled or a pulse is present, apply a second tourniquet proximal side by side to the first.

b) After applying the second tourniquet, make sure bleeding and pulse have stoped.  Do not remove the first tourniquet.

c)  If the second tourniquet does not stop the bleeding, prepare the wounded for transport.

9.  Secure the rod inside the clip with help of the rod securing strap.  Now the tourniquet is applied and the casualty is ready for transport.  If the wounded individual is not being transported immediately, periodically check the status of the tourniquet.

Write the letter “T” and record the time of application on the skin of the casualty using a permanent marker.  The letter “T” will inform medics that a tourniquet was applied.  On the CAT tourniquet there is place on the white strap to record this information.

 

b.  One-Handed Application

CAT tourniquet application

 A tourniquet can be applied using one hand when there is an injury to an upper limb (arm or forearm).

1. Remove the tourniquet from the first aid kit.

2.  Slide the wounded extremity through the loop of the self-adhering band.

3.  Position the tourniquet 5 centimeters above the wound.

4.  Pull the band very tight and securely fasten the band back on itself.

5. Adhere the self-adhering band around the limb.

Do not adhere the band past the rod clip.

6.  Twist the windlass rod until bright red bleeding has stopped and the distal pulse is eliminated.  Darker bleeding from the veins may continue for a while.

7.  Place the rod inside the clip and lock it into place.

8.  Check to make sure that arterial bleeding has stopped and that the distal pulse is not present.  If the bleeding continues and the pulse hasn’t stopped, it is imperative to tighten the tourniquet using the rod.

9.  Adhere the band over the rod, inside the clip and fully around the limb and secure the band with the windlass strap.

10.  Secure the rod and band with the help of the strap.  The tourniquet is now properly applied and the casualty is ready for transport.  If the wounded individual is not being transported immediately, periodically check the status of the tourniquet.

Additional Information

Video Instruction from North American rescue on applying the rouniquet to arms and legs.

More research about the effectiveness of the CAT tourniquet

PATRIOT DEFENCE: ENLIGHTENMENT THROUGH MEDICINE • A HUMANITARIAN INITIATIVE OF THE UKRAINIAN WORLD CONGRESS
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