Nachman Dean, Benov Avi, Shovali Amiram, Nirit Yavnai, Nadler Roy, Avraham Yitzhak, Glassberg Elon
Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military POB 02149 Tel Hashomer, Ramat Gan, Israel, Military Postal Code 01215.
Mil Med. 2017 Mar;182(S1):53-58. doi: 10.7205/MILMED-D-16-00126.
The Combat Application Tourniquet (CAT) is the tourniquet of choice in the Israeli defense forces. Applying the device loosely before windlass twisting is a main pitfall in CAT application. This study objective is to assess the effectiveness of a novel design modification of the CAT, aiming to prevent loose applications, by minimizing the slack.
Using the HapMed leg tourniquet trainer, an above the knee traumatic amputation was simulated. Active duty combatants and Special Forces basic medics were randomly assigned to apply the modified (n = 67) or conventional CAT (n = 65) once. Applied pressure, hemorrhage control status, time to stop the bleeding, and estimated blood volume loss were measured.
Using the modified CAT, the mean (±SD) pressure applied was significantly higher compared to the conventional one (231.49 ± 37.84 mm Hg vs. 213.31 ± 45.51 mm Hg, p < 0.05). Hemorrhage control rate was 86.6% in the modified CAT group versus 67.7% in the conventional CAT group (p < 0.05). Analyzing only the applications that succeeded in hemorrhage control, blood loss (171.12 ± 72.43 mL vs.187.75 ± 91.72 mL, p > 0.05) and time to stop bleeding (27.27 ± 13.15 seconds vs. 27.5 ± 11.25 seconds, p > 0.05) were similar.
The modified CAT demonstrated an upgraded pressure profile and hemorrhage control rate, potentially indicating its improved efficacy.
战斗应用止血带（CAT）是以色列国防军选用的止血带。在旋转绞盘之前将该装置宽松地应用是CAT应用中的一个主要缺陷。本研究的目的是评估一种新型设计改进的CAT的有效性，旨在通过最小化松弛来防止宽松应用。
使用HapMed腿部止血带训练器，模拟膝上创伤性截肢。现役战斗人员和特种部队基础医务人员被随机分配一次应用改良型（n = 67）或传统型CAT（n = 65）。测量施加的压力、出血控制状态、止血时间和估计的失血量。
使用改良型CAT，施加的平均（±标准差）压力显著高于传统型（231.49±37.84毫米汞柱对213.31±45.51毫米汞柱，p<0.05）。改良型CAT组的出血控制率为86.6%，而传统型CAT组为67.7%（p<0.05）。仅分析成功控制出血的应用，失血量（171.12±72.43毫升对187.75±91.72毫升，p>0.05）和止血时间（27.27±13.15秒对27.5±11.25秒，p>0.05）相似。
改良型CAT显示出升级的压力分布和出血控制率，可能表明其疗效有所提高。
