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:  

1. mechanical and application failures;
2. 2: application times;
3. flow versus no-flow, as measured by Doppler stethoscope;
4. percentage circulatory occlusion; as measured by impedance plethysmography (IPG)
5. 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.