In the past few years, there has been a big change in how we view tourniquets. Where they were once thought to cause limb damage, we now know that tourniquets save lives. The risk of limb damage is actually very low, but the potential to save life is huge.
Thus, campaigns like Stop the Bleed are working to train the public about tourniquets.
If you aren’t sure how to use a tourniquet, read our article on the topic. It goes over the step-by-step instructions on how and when to apply.
Yes, Choice of Tourniquet Matters
In a disaster situation where you have nothing else, an improvised tourniquet – such as a bandana or piece of torn clothing – is better than nothing. However, improvised tourniquets are likely to fail.
Tourniquets must apply huge amounts of pressure in order to collapse veins and arteries. Weak, flimsy materials simply can’t exert this much pressure. Further, the tourniquet must be secured in place.
The two tourniquets we recommend have systems which allow for tightening and securing it. These tourniquets are proven to work.
Recommended Tourniquets: CAT-7 and SOFTT-W
There are only two tourniquets we can recommend. The first is the Combat Action Tourniquet 7th Generation (CAT-7) made by North American Rescue. The other is the Special Operations Forces Tactical Tourniquet – Wide (SOFTT-W) made by TacMed.
These are the main tourniquets which were carried by soldiers in Operations Enduring Freedom (OEF), Iraqi Freedom (OIF), and New Dawn (OND). They are used by police officers, EMS paramedics, the American Red Cross, and approved for use by the Department of Defense.
They are proven to work and recommended by the Committee on Tactical Combat Casualty Care (CoTCCC).
Combat Application Tourniquet Generation 7 (CAT-7)
Special Operations Forces Tactical Tourniquet (SOFTT)
CAT vs. SOFTT Tourniquets
Of the two tourniquets, CAT is carried by more police officers, soldiers, and paramedics. However, this doesn’t mean that the CAT is better than the SOFTT. Both are very good tourniquets.
There are a few differences between them.
- Width: CAT is 1.5” wide; the original SOFTT is only 1” wide. Choose the upgraded SOFTT-W (recommended here) which is also 1.5” wide.
- Material: CAT is made from Velcro-backed webbing. SOFTT is made of a thicker webbing.
- Weight: SOFTT is heavier at 4.3 oz (vs. 2.2oz) because of its thicker webbing and heftier hardware.
- Buckle: CAT uses a traditional buckle whereas SOFTT has a gator-strip buckle
- Windlass lock: CAT uses a hook system followed by velcro. SOFTT uses a D-ring.
Unless you are a trained medical professional who uses tourniquets often, these differences probably won’t mean anything to you.
I personally would stick with the CAT tourniquet. It is more widely used so you’re more likely to find it in emergency situations. Further, some claim that it’s easier to put the CAT tourniquet in place. (1)
When looking at tourniquets, you’ll want one that is recommended by the CoTCCC. The group actually tests tourniquets under stress with doppler sonograms to determine whether they will fail.
The CoTCCC is made up of trauma surgeons, combat medics, emergency physicians, and others who have a vested interest in the quality of medical equipment. The group is endorsed by the American College of Surgeons and the National Association of EMTs.
Currently, the CoTCCC only recommends the CAT and SOFTT tourniquets. Thus, these are the only ones we can in good faith recommend.
CoTCCC vs. TCCC
Be warned: CoTCCC is not the same as TCCC Approved. The CoTCCC doesn’t approve tourniquets or other medical devices.
WARNING: Counterfeit Tourniquets
You’d be surprised what a huge problem counterfeit tourniquets is. The FDA issued a warning about it as far back as 2010. The problem hasn’t resolved since then. Interpol Washington had to issue an Orange warning because the fakes pose such a risk. The fakes have shown up everywhere, even at the US military.
How dangerous are counterfeit tourniquets? Consider what happened in New Hampshire.
Two paramedics responded to a motorcycle crash. The victim had uncontrolled bleeding, so they went to apply a tourniquet. The CAT turned out to be a fake. While applying it, they experienced a “catastrophic failure” when the rod snapped in half. The tourniquet couldn’t be tightened and the victim lost his life.
How to Spot Take Tourniquets:
- Price: If the price seems too good to be true, it probably is. Don’t be stingy when buying equipment meant to save lives.
- Unknown Seller: CAT tourniquets are made by North American Rescue and only sold by authorized distributors.
- Logo and Supply Number: Real CAT tourniquets will have the CAT logo and supply number on its side.
- E-CAT tourniquets are fake. These cheap knockoffs are made by a company in China. You can read about how to spot these fakes here.
Choosing a Tourniquet
There are only two tourniquets that we can recommend: The CAT-7 and the SOFTT-W tourniquet. These are the only ones which have been recommended by the CoTCCC. Again, I warn you against buying cheap tourniquets because their tension rods or buckles could easily snap.
I’ll still go over the features you need to look for when choosing a tourniquet though. Knowing these features can help if you need to make an improvised tourniquet.
Never use a thin tourniquet like a narrow tube. These are more likely to cause tissue damage and will be much more painful for the patient.
You need a wide tourniquet which can put pressure on a larger area of tissue. The CAT-7 and SOFTT-W tourniquets are 1.5 inches wide.
Tourniquets for Children
Tourniquets tend to be “one size fits all” and designed with soldiers in mind. If you have small children, the CAT and SOFTT tourniquets might not work on them.
This study found that many tourniquets didn’t work on small limbs. The CAT tourniquet failed on arms with a 5cm diameter. The SOFTT tourniquet started failing at 6.35cm diameter arms.
Only the SWAT, TacMed K9, RATS, and Child Ratcheting Medical tourniquets were successful in stopping blood flow on all sized mannequins. So, even though these tourniquets aren’t recommended by CoTCCC, they might be the best choice if you have children. They could also be used for pets.
Of these, we recommend the TacMed K9.
Types of Tourniquets
There are four types of tourniquets. Of these, we recommend getting a windlass tourniquet (both CAT and SOFTT are windlass).
They are easier to apply with one hand. Further, they are more reliable. The windlass tightening system makes it easier to get enough pressure. You can’t do this with other types of tourniquets.
Though simple, these tourniquets are very effective. They consist of a strap in a loop shape which goes over the limb. The windlass is usually a rod which gets turned to tighten the strap.
If you need to make an improvised tourniquet, you will also want to use the windlass system. This will allow you to get the tourniquet tighter.
These tourniquets are made from long pieces of elastic or a stretchy material. To use, you wrap them around the limb several times then tuck in the end. They are easy to use but hard to get enough pressure with them.
If you’ve ever worn ski boots, you’ll be familiar with the ratcheting system used in these tourniquets. These are not recommended. There is a high rate of failure because skin or clothing can get in the ratcheting system.
These are also not recommended for most people. They use an inflatable bladder to create pressure and stop blood flow. They are more difficult to apply and generally only seen in hospitals. (8)
Other Tourniquet Features
- Smooth material: You want the tourniquet to be smooth without any bumpy edges. Tourniquets which aren’t uniform are more likely to cause tissue damage.
- Easy to use: You should be able to figure out the tourniquet intuitively.
- Durability: This goes back to what we said about avoiding cheap, counterfeit tourniquets. The windlasses can easily snap on these, causing them to fail.
Having Your Tourniquet Ready
If you don’t have your tourniquet with you when needed, then it will be useless. A simple solution is to get a tourniquet carry case.
They are mostly available as belt pouches, ankle holsters, or with MOLLE webbing. You’ll want one that has a pull tab for quick deployment.