NAVSEA Evaluation
EVALUATION OF SELF-APPLIED TOURNIQUETS FOR COMBAT APPLICATIONS, SECOND PHASE
Results released: April 2007
Conducted by: Naval Sea Systems Command- Navy Experimental Diving Unit
This information is a summary of the full report.
Introduction:
Mortality statistics from Operation Iraqi Freedom (OIF) indicate that deaths among U.S. forces are often not immediate but from hemorrhagic shock following the detonation of improvised explosive devices (IED’s). U.S. troops are currently equipped with Devlar body armor and helmets what have decreased the number of fatalities resulting from penetrating chest wounds and serious head trauma, but the number of deaths attributable to extremity wounds have increased. Evidence suggests that approximately 7% of these deaths could be prevented with the prompt application of an effective tourniquet
General: Twenty-eight active duty Navy personnel served as test subjects. Tourniquets were immersed in a blood analog solution and then rolled in sand to simulate desert combat (field) conditions
Experimental Design: Combinations of tourniquets and extremities were tested in a repeated measured design based on the following parameters:
- mechanical and application failures;
- 2: application times;
- flow versus no-flow, as measured by Doppler stethoscope;
- percentage circulatory occlusion; as measured by impedance plethysmography (IPG)
- subjective ratings of tourniquets by test subjects
Thirteen (13) different tourniquets were included in the Evaluation.
In this evaluation the RMT was called the ‘Burke’ by DOD distributor. The Burke was created, designed and produced by m2
® inc. It was generation 5. The current RMT is generation 24.
GRAPHS:
|
MECHANICAL AND APPLICATION FAILURES |
|
|
|
|
| TOURNIQUET |
FAILURE RATE % |
GROUP |
| FST |
2 |
1 |
| MET |
2 |
1 |
| TK-4 |
2 |
1 |
| CAT |
4 |
1 |
| MAT |
4 |
1 |
| OHT-2 |
4 |
1 |
| Q |
4 |
1 |
| RMT |
6 |
1 |
| NATO |
6 |
1 |
| SOFT-T |
6 |
1 |
| McMill |
8 |
1 |
| TK-3 |
8 |
1 |
| TIAM |
28 |
3 |
|
APPLICATION TIMES |
|
|
UPPER EXTREMITY |
|
|
|
|
| TOURNIQUET |
MEAN APPLICATION TIME (sec) |
GROUP |
| OHT-2 |
57.6 |
1 |
| RMT |
59.9 |
1 |
| MAT |
60.7 |
1 |
| TK-3 |
70.4 |
1 |
| Q |
72.3 |
1 |
| TK-4 |
72.8 |
1 |
| TIAM |
83.9 |
1 |
| FST |
95.1 |
1 |
| CAT |
97.1 |
1 |
| MET |
100.9 |
2 |
| SOFT-T |
129.6 |
3 |
| NATO |
138.9 |
3 |
| McMill |
161.4 |
3 |
|
APPLICATION TIMES |
|
|
LOWER EXTREMITY |
|
|
|
|
| TOURNIQUET |
MEAN APPLICATION TIME (sec) |
GROUP |
| OHT-2 |
41.8 |
1 |
| MAT |
46.6 |
1 |
| RMT |
48.8 |
1 |
| Q |
53.7 |
1 |
| MET |
54.1 |
1 |
| TK-3 |
54.2 |
1 |
| SOFT-T |
56.3 |
1 |
| CAT |
57.9 |
1 |
| FST |
60.7 |
1 |
| TK-4 |
65.3 |
1 |
| NATO |
71.4 |
2 |
| TIAX |
75 |
2 |
| McMill |
89.9 |
3 |
|
DOPPLER FLOW MEASUREMENTS |
|
|
UPPER EXTREMITY |
|
|
|
|
| TOURNIQUET |
% NO FLOW |
GROUP |
| TIAX |
100 |
1 |
| CAT |
92 |
1 |
| MAT |
92 |
1 |
| RMT |
91.67 |
1 |
| TK-3 |
87.5 |
1 |
| MET |
84 |
1 |
| TK-4 |
80 |
1 |
| FST |
72 |
1 |
| Q |
69.57 |
1 |
| SOFT-T |
68.18 |
1 |
| OHT-2 |
58.33 |
1 |
| McMill |
27.27 |
3 |
| NATO |
21.74 |
3 |
|
DOPPLER FLOW MEASUREMENTS |
|
|
LOWER EXTREMITY |
|
|
|
|
| TOURNIQUET |
% NO FLOW |
GROUP |
| CAT |
73.91 |
1 |
| RMT |
69.57 |
1 |
| MAT |
69.57 |
1 |
| TIAX |
65 |
1 |
| Q |
56 |
1 |
| TK-4 |
54.17 |
1 |
| TK-3 |
50 |
1 |
| SOFT-T |
48 |
1 |
| MET |
33.33 |
1 |
| FST |
25 |
1 |
| McMill |
25 |
1 |
| NATO |
8.33 |
2 |
| OHT-2 |
0 |
3 |
|
SUBJECTIVE RATINGS |
|
|
|
|
| TOURNIQUET |
TOTAL SCORE |
GROUP |
| MAT |
289 |
1 |
| RMT |
229 |
1 |
| TK-3 |
225 |
1 |
| TK-4 |
210 |
1 |
| CAT |
208 |
2 |
| TIAX |
198 |
2 |
| Q |
196 |
2 |
| MET |
172 |
2 |
| OHT |
133 |
2 |
| McMill |
125 |
2 |
| SOFT-T |
122 |
3 |
| FST |
114 |
3 |
| NATO |
54 |
3 |
|
TOTAL POINTS RANKING BASED ON GROUP ASSIGNMENTS |
|
|
|
|
|
|
|
|
|
|
| TOURNIQUET |
GROUP 1 |
GROUP 2 |
GROUP 3 |
TOTAL POINTS |
FINAL GROUP |
| RMT |
8 |
0 |
0 |
24 |
A |
| MAT |
8 |
0 |
0 |
24 |
A |
| TK-3 |
8 |
0 |
0 |
24 |
A |
| TK-4 |
8 |
0 |
0 |
24 |
A |
| CAT |
7 |
1 |
0 |
23 |
B |
| Q |
7 |
1 |
0 |
23 |
B |
| MET |
6 |
2 |
0 |
22 |
B |
| FST |
7 |
0 |
1 |
22 |
C |
| SOFT-T |
6 |
0 |
2 |
20 |
C |
| TIAX |
5 |
2 |
1 |
20 |
C |
| OHT-2 |
5 |
2 |
1 |
20 |
C |
| McMill |
2 |
2 |
4 |
14 |
C |
| NATO |
1 |
3 |
4 |
13 |
C |
CONCLUSIONS:
Each of the thirteen tourniquets was subjected to 50 trials and evaluated on the above parameters. Using the artificial construct designed for this study and weighing all parameters equally the RMT (Burke), MAT, TK-3, and TK-4 performed equally with scores of 24 out of 24 points possible.
RECOMMENDATIONS:
From the data obtained and analyzed in this study, it is recommended that one of the tourniquets that achieved a Group A rating (statistically equal to or better than all other tourniquets in every parameter tested) be highly favored in selection for forward deployment.
