Which Tourniquet Should I Choose?

Severe bleeding is bad. “Bleeding out” can occur in less than 5 minutes.

Average response time for EMS in the USA? 8 minutes.

This is a strong argument for carrying a tourniquet on your person, every day.

It can’t stop everything, as it’s only useful on extremities (arms, legs), but it’s still quite useful. It’s also been awesome to see tourniquets gaining more mainstream attention. For example, at the 2013 Boston Marathon bombing, tourniquets were used and reported on by the mainstream media. At the 2017 Ariana Grande Manchester attack, people used tourniquets to save their own lives.

But there was one problem? They were all improvised tourniquets.

Yes they were better than nothing, but it’s well-established that purpose-built tools perform better than improvised (it’s why you might be able to use your shoe to pound the nail into the wall, but a hammer works better).

My Current Choice

Presently, I carry a SOF Tactical Tourniquet Wide (SOFTT-W) from Tactical Medical Solutions. I carry it in a PHLster Flatpack TQ Carrier.

Why?

The other big choice in tourniquets is the Combat Application Tourniquet (C-A-T). I’ve used both, including through scenario-driven classes with Lone Star Medics. Both are proven and TCCC approved, and really either one is fine. I came down on the side of the SOFTT-W for a few reasons.

The metal windlass is nice, because plastics can degrade and break. Yes metal can too, but far less likely.

The detachable buckle is useful, facilitating getting around things you can’t move. While you can pull the strap out of the C-A-T buckle, you then have to re-thread it, which is harder to do than simply latching the buckle.

Slim. Look how thin a flatpacked SOFTT-W is:

I have no problems putting that in an inner pocket in my cargo pants every day. It’s very easy to carry.

C-A-T Revisited

During the Dark Angel Medical D.A.R.T. class I took, Kerry preferred the C-A-T, and we got to work with the new 7th generation C-A-T’s.

I have to say, they weren’t as bad to work with as my past experience.

Applying them one-handed was generally much easier than the SOFTT-W. That I could just pull through the buckle and hit the hook-and-loop closures ran smoother (and thus faster) than through the friction/tightening mechanism of the SOFTT-W’s buckle. I was able to get things tight and not have the TQ shift around on me, nor worry about “angle of pull” to get things tight. And of course, the big windlass retaining hooks on the C-A-T are so simple to use. That is one thing that’s hard with the SOFTT-W in one-handed operation: getting the windlass into the retaining triangle. I think the SOFTT-W’s retaining mechanism is more sturdy and provides better retention, but for sure it’s not as easy to engage.

But I did say generally easier. I have larger and longer legs. Trying to apply the C-A-T around my legs wasn’t easy, because that great hook-and-loop that holds holds always. So when the TQ is staged, the loop isn’t big enough to fit around my legs – plus I have to thread it all the way up my leg. Else I have to rip the hook-and-loop apart, then pull the strap out of the buckle, then thread it back through. OR I have to stage it with a very large loop, but then it became more difficult to apply to smaller diameter areas like an arm. It’s something I’ll continue to work with to see if I can find a happy medium.

Looks like you can flat fold a C-A-T as well:

but it still won’t be as flat as a SOFTT-W. Also notice that if you do flat fold it, there are some issues you have to work with on deployment – will you remember that under stress (and blood loss)?

In the end, I’m a little more open to the C-A-T, due in part to the 7th generation improvements.

Anything else?

One TQ that Kerry Davis (Dark Angel’s honcho) brought out was the SWAT-T. If you will, it looks like a long, wide strip of rubber. Just wrap it around and go.

Hrm.

There’s some controversy about this TQ, questions of efficacy. Kerry sells kits that only have the SWAT-T in it, and he said to me that he would have no problems if that was his primary and only TQ. No qualms, no reservations. So take that as you will.

To me, the jury is still out. There’s information, but not enough for me.

But that said, one thing I found compelling about the SWAT-T is versatility. It can be used as a TQ, or it could be used as a bandage or pressure dressing, along with other uses limited only by your imagination. That sort of versatility can be welcome when you have only so much room for gear, but have to fill a lot of roles. Plus, the SWAT-T, in its original packaging, is much smaller than the C-A-T or the SOFTT-W. However, life has taught me that when you need the best, unitaskers – things that specialize, focus, and strive solely to fulfill that role – generally work better than multitaskers, since the multitasker generally has to make compromises to fulfill the multiple roles. Life is often about tradeoffs, so trade as your context and risk-tolerance can afford.

My changing perspective

My EDC will remain a SOFTT-W in a PHLster Flatpack, because it’s proven and fits my every day carry.

When I need to buy more TQs for other roles, like the larger kit in my truck, in my briefcase, around the house, etc – places where size/bulk aren’t much of an issue, I’ll probably add C-A-Ts to the mix. I’m not saying I’ll replace one with the other, but I’m willing to supplement. I find both the SOFTT-W and C-A-T to be strong, but still have their drawbacks; neither is perfect to me, but the quibbles are minor.

And I might even see where a SWAT-T could fit in. I am not willing to make it a primary, but I could see it as a supplement in a kit. That it provides for some different uses can make it useful in a tight kit, including being a secondary TQ if needed.

Don’t take my word for it.

Get training. It could be from Dark Angel Medical or Lone Star Medics or another reputable source. Work with the equipment, see how they work, their strengths and weaknesses, their pros and cons. Figure which will work best in your situation, and realize that you may have multiple situations and they could require different solutions.

Just don’t delay. You don’t get to choose when bad things happen in your life, and you don’t want your last 5 minutes to be wishing you had a tourniquet.

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4 thoughts on “Which Tourniquet Should I Choose?

  1. I also utilize the SOFFT-W as my edc TQ, though I have CATs in other medical kits I have around in the truck, the house, etc.

    I like the rugged nature of the SOFFT-W, but freely admit that it’s a bit of a b$#tch to get on one-handed. At the Unthinkable class on 1/21/17, we got quite a few reps putting our TQ of choice on during both live fire exercises and not. A few times I was able to make Caleb’s par time of 12 seconds, other times, I was sitting there at 30 plus wrestling with the triangle retainer. It’s a TQ that definitely requires some practice for sure! However, I do feel like it’s robustness along with how flat I’m able to fold it earns it a spot in my EDC. Like you said, you just have to find the correct “angle of pull” to get the slack out of the SOFFT-W which can be tricky, but I take that as a training issue on my part. Reps on reps on reps are the answer.

    • I will say, I’m not 100% sure “reps” are the answer here. Because if we’re looking at a one-handed application, that means I am the one that’s rapidly losing blood! I think it’s reasonable to assume my mental state will be altered, and even 10,000 reps may not get me there.

      But I honestly do not know. It’s something I’m going to engage those with greater knowledge about.

      The CAT is hard for me to fit into EDC, but no question it was a LOT easier to apply 1-handed (at least to my arms). Plus, I think the CAT is easier for “less trained” folks to apply, so I think it makes a better fit in kits.

      I’m working on buying a CAT trainer (I’ve got a couple SOFTT-W trainers, courtesy of Caleb). I’ll want to do some side-by-side comparison runs to see how I do.

      And who knows. Obviously my opinion changed recently. After I acquire more knowledge, I’d reason my opinion could change again. I’m not married to anything, other than Truth and “what’s best”.

      • I agree, reps may not be the whole solution. I guess what I meant was, at least when trying to quickly get the SOFFT-W on one-handed during Unthinkable, after a few tries I started to learn the angle that the buckle seems to like so that the slack can be pulled out almost completely in one go. Some of that also was very dependent on how I had the TQ sandwiched between my armpit and chest. Definitely takes some familiarity. With more reps I think I could get closer to getting it on the first try and in the shortest amount of time. Under duress, you’re right, that might all go out the window.

        I guess in a perfect world we’d have a TQ that can pack as small as the SOFTT-W and work as quickly as the CAT when doing it one-handed. I guess I’ll keep practicing in the meantime.

        • Yup. That’s the thing – it feels like, for one-handed, there’s a lot of factors to “get right” to make it happen and not a struggle. I didn’t find those with the latest gen of the CAT, but then the CAT had its own struggles.

          So like you said – which is what I alluded to at the end of my article – both are good, but neither is ideal. If there’d be some way to hybrid them and take all the best from each, yeah. But until then, just keep practicing. Best we can do. 🙂

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