Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
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Uncontrolled hemorrhage is the leading cause of preventable prehospital death on the battlefield; 20% is junctional. This is a challenge to manage in the forward and prehospital military environment. With the widespread use of body armor, peripheral tourniquets and continued asymmetric warfare this consistent figure is unlikely to reduce. ⋯ Importantly it has a low training burden and is easy to use. The AAJT has potential use as a prehospital device in the exsanguinating patient, those in traumatic cardiac arrest, as a bridging device, and as fluid conserving device in resource-limited environments. The evidence surrounding the AAJT is reviewed, and potential uses in the military setting are suggested.
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Tourniquets have become ubiquitous tools for controlling hemorrhage in the modern prehospital environment, and while commercial products are preferable, improvised tourniquets play an important role when commercial options are not available. A properly constructed improvised tourniquet can be highly effective provided the user adheres to certain principles. This review article identifies key skills in the construction and application of improvised tourniquets on an extremity. ⋯ After torque is applied, the rod must be secured into position to maintain the constricting force and survive patient transport. Finally, the need for an improvised tourniquet is a contingency that all first responders should anticipate. Hands-on training should be conducted routinely in conjunction with other first responder tasks.