Tourniquets are a hot topic again: they save lives in traffic accidents, on the mountain or in military conflicts – if you know how to use them and make the right choice. To get a feel for the market, we had three experts from Critical Knowledge test common “TQs” for Ranger Magazine (made by Militär Aktuell) to determine their practicality.

©Military NewsTourniquets have accompanied mankind for thousands of years. One of the oldest examples is documented in Indian records from more than 2,500 years ago. Since then, we have found tourniquet systems designed to prevent severe blood loss in the event of serious injuries to extremities in almost every civilian and, above all, military scenario up until the 1970s and 1980s. In the years following the Vietnam War, however, a dispute arose as to whether their use was a curse or a blessing for the broad mass of soldiers and the population. Consequential damage was feared if the wrong indications were given, and so it was only around ten years later that the evaluation of US special forces missions led to the realization that tourniquets must be available for use again, as they are today in Ukraine. In recent years, civilian medicine has also followed suit.

Function and application

Lifesavers - 10 tourniquets put to the test by experts -©Sebastian Freiler
Johannes Kouba is a NATO Special Operations Combat Medic (NSOCM), emergency and firefighter paramedic. As the owner of Critical Knowledge Austria, he offers customized training for civilians, hunters, marksmen, government users, businesses and large-scale industry.

How exactly does a tourniquet work? An extremity tourniquet, also known as a tourniquet, is a tourniquet system with the purpose of stopping the venous and, above all, arterial blood flow in the affected extremity and thus stopping the bleeding. The tourniquet is applied as high as possible or about five to seven centimetres above a heavily bleeding wound and pulled taut. Then, with the vast majority of models – in our test all but the RapidStop tourniquet and the SWAT-T tourniquet – the connected traction band is increasingly tightened by turning the toggle so that the necessary pressure is exerted on the tissue and thus on the blood vessels until the blood flow is stopped. The gag is then fixed with the respective holder, the excess length is treated and the application time is entered.

The other two models in the test series are either attached to the extremity using a predefined wrapping technique (SWAT-T tourniquet) or brought to the desired tension using a mechanical pulling device similar to the fastening of ski boots or bindings (RapidStop tourniquet).

Only for specialists?

As human life is the highest of all legal interests protected by the legal system, in emergency situations even laypersons in Austria are legally obliged to provide first aid. Failure to do so constitutes a criminal offense. Whether the specific measures taken in the course of providing first aid are also covered by law, or whether they were practiced excessively, will depend on the knowledge and skills acquired by the layperson in advance.

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Incorrect or excessive first aid can even lead to more damage and thus to liability. The choice of means must therefore be correctly assessed and applied with sufficient training. Without the right measures, such as a tourniquet, life-threatening extremity bleeding can be fatal within five minutes.

Material

While the ancient Romans still had to work with primitive tying systems made of leather and bronze, modern tourniquets are made of plastic or metals from aircraft technology. Depending on the area of application, there are variations in the material, functional principle and product size. We always recommend purchasing an additional tourniquet for regular training in order to save the “sharp” tourniquet for emergencies.

Lifesavers - 10 tourniquets put to the test by experts -©Sebastian Freiler
TESTCREW – Johannes Kouba conducted our big Tourniquet comparison test. He had two supporters from his team at his side, who did not want to be seen in the picture due to their membership of the Austrian special forces.

This is how we tested

The brief to the Critical Knowledge team – including civilian paramedics and combat medics – was to provide a decision-making aid for both the lay responder and the professional user when purchasing a Tourniquet for use on adolescents or adults.

We tested ten tourniquets available in Europe for you. These include models recommended by the Committee on Tactical Combat Casualty Care (CoTCCC), the leading network for the development of medical guidelines in the tactical environment (CAT7, TMT, SAM XT, SOF Gen 4), relatively recent developments (RapidStop Tourniquet, TQ Dnipro) and a tourniquet that was purchased very cheaply from a large mail order company (replica tourniquet). For the sake of transparency, a reference to a test bias: All test subjects have been users of CAT and SOF tourniquets in official use.

Except for a tourniquet (TQ Dnipro), all models were procured privately. As this product has not been on the market for long and sales are currently concentrated in the Ukraine, we wrote to the manufacturer to ask for test samples, which we were kind enough to receive. We will endeavor to provide further tests online for models that are primarily represented on the US market and are currently difficult to obtain in Europe.

The test series was very much geared towards practice and not so much towards laboratory-like conditions. Nevertheless, in order to obtain objective measurement parameters, the blood flow of the respective extremity was measured using a Doppler ultrasound device. The test subjects also had to independently document any abnormalities in the respective tourniquets using an evaluation form.

For the cold test, the tourniquets were frozen for 14 hours at -24 degrees Celsius and then tested. In the heat test, the tourniquets were heated at 50 degrees Celsius for one hour before use. We again tested the usability in case of heavy soiling by soaking the opened tourniquets in a bucket of mud and putting them on immediately afterwards. The application with winter gloves and over thick outerwear (long underwear, trousers and pullover, Carinthia HIG 4.0 jacket and MIG 4.0) is also very realistic and was also included in the test.

In addition, we measured the efficiency of self-application and application by others, the required training intensity of the user and the subjective impression of the feel and feel of the application.

The tested tourniquets:

Click here for further product tests.

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