Evaluation of Two Junctional Tourniquets Used on the Battlefield:  Combat Ready Clamp(r) versus SAM(r) Junctional Tourniquet

Meusnier, Jean-Guillaume; Dewar, Charles; Mavrovi, Erti; Caremil, Frédéric; Wey, Pierre-François; Martinez, J.-Y.

doi:10.55460/4gwf-k0ak

Cited by 13 publications

(3 citation statements)

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“…Meusnier et al published a study on the effectivity of SJT ® that was applied to the groin region by trained military nurses. [ 20 ] They showed that the successful SJT application rate was 86.8%. On the other hand, Flecha et al compared the performances of combat medics and combat lifesaver personnel after a single junctional tourniquet application on mannequins for training purposes.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, participants in other studies also preferred SJT ® over other junctional tourniquet types. [ 20 , 21 ] Compared to the T-AJT ® , the SJT ® is smaller and lighter; its application causes less pain and can be applied more quickly. Future developers of junctional tourniquets may need to consider these findings, as final users’ preferences are also of critical importance.…”

Section: Discussionmentioning

confidence: 99%

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Results of combat medic junctional tourniquet training: a prospective, single-blind, randomized, cross-over study

Kaymak

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Bleeding remains the leading cause of potentially preventable deaths both in military and civilian pre-hospital trauma settings. Conventional extremity tourniquets do not control bleeding if an iliac artery or a common femoral artery is injured. Stopping junctional bleeding is particularly challenging and requires the use of specifically designed junctional tourniquets. SAM ® Junctional Tourniquet (SJT ® , United States of America) and Tactical Abdominal Junctional Tourniquet (T-AJT ® , Fora Group Türkiye) have been actively used by Turkish security forces. This study questioned the effect of training on combat medics’ successful junctional tourniquet applications and application times (AT). METHODS: Our research on two different junctional tourniquet models was designed as a prospective randomized, crossover, single-blinded study. All 40 participants in the study were attendees of a 12-week combat medic training course with updated medical approvals, which were used as an eligibility criterion. Randomization was performed by drawing T-AJT®-SJT cards. The study consisted of pre-training and after-training tourniquet application phases. In each study phase, all participants’ AT and the presence or absence of arterial flow were recorded for each group. Finally, the combat medics were presented with a 6-question survey. RESULTS: Although training increased successful T-AJT ® application rates, training was not statistically significantly associated with successful applications for any tourniquet types (p>0.05). The pre-training phase ATs for SJT ® and T-AJT ® were 55±11.8 and 93.8±2.9 seconds, respectively, and the difference was statistically significantly different (p<0.001). Likewise, after-training phase ATs for SJT ® and T-AJT ® were 49±22.6 and 79.2±17.5 seconds, respectively, and participants’ SJT ® ATs were significantly shorter (p<0.001). Overall, when participants’ applied any of the tourniquet unsuccessfully, the odds of participants’ lower Visual Analogue Scale scores were 0.2 (95% CI [0.08, 0.49]. p<0.001). CONCLUSION: Our study basically investigates the effects of training on effective tourniquet application. Unfortunately, our after-training success rates remained unsatisfactory when compared to other studies. This is also the first study on T-AJT ® tourniquet application, and further studies on its efficacy are also required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Results of combat medic junctional tourniquet training: a prospective, single-blind, randomized, cross-over study

Kaymak

2024

Ulus Travma Acil Cerrahi Derg

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“…When necessary, SJT can be used as a pelvic fixator or axillary hemostat with a shoulder accessory. Because of its efficacy and relatively mild pain [ 73 , 81 ], SJT is more favored among tourniquets [ 73 , 83 , 96 ]. Regrettably, due to the lack of clinical and laboratory data, the positive role of SJT in air transport has been solely clarified.…”

Section: Torso Hemorrhage and Its Noncompressibility: Nothing Is Impo...mentioning

confidence: 99%

Torso hemorrhage: noncompressible? never say never

Zhang,

Zhang

2024

Eur J Med Res

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Since limb bleeding has been well managed by extremity tourniquets, the management of exsanguinating torso hemorrhage (TH) has become a hot issue both in military and civilian medicine. Conventional hemostatic techniques are ineffective for managing traumatic bleeding of organs and vessels within the torso due to the anatomical features. The designation of noncompressible torso hemorrhage (NCTH) marks a significant step in investigating the injury mechanisms and developing effective methods for bleeding control. Special tourniquets such as abdominal aortic and junctional tourniquet and SAM junctional tourniquet designed for NCTH have been approved by FDA for clinical use. Combat ready clamp and junctional emergency treatment tool also exhibit potential for external NCTH control. In addition, resuscitative endovascular balloon occlusion of the aorta (REBOA) further provides an endovascular solution to alleviate the challenges of NCTH treatment. Notably, NCTH cognitive surveys have revealed that medical staff have deficiencies in understanding relevant concepts and treatment abilities. The stereotypical interpretation of NCTH naming, particularly the term noncompressible, is the root cause of this issue. This review discusses the dynamic relationship between TH and NCTH by tracing the development of external NCTH control techniques. The authors propose to further subdivide the existing NCTH into compressible torso hemorrhage and NCTH’ (noncompressible but REBOA controllable) based on whether hemostasis is available via external compression. Finally, due to the irreplaceability of special tourniquets during the prehospital stage, the authors emphasize the importance of a package program to improve the efficacy and safety of external NCTH control. This program includes the promotion of tourniquet redesign and hemostatic strategies, personnel reeducation, and complications prevention.

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