Role of the Windlass in Improvised Tourniquet Use on a Manikin Hemorrhage Model
Abstract
In emergencies when commercially de - signed tourniquets are unavailable, hemorrhage may need to be controlled with improvised tourniquets. In the aftermath of the Boston Marathon bombing, no improvised strap-and-windlass tourniquets were used to treat casualties; tourniquets without windlasses were used. The purpose of the present study is to determine the effectiveness of improvised tourniquets with and without a windlass to better understand the role of the windlass in tightening the tourniquet strap. Methods: An experiment was designed to test the effectiveness of improvised strap-and-windlass tourniquets fashioned out of a tee shirt on a manikin thigh. Two users conducted 40 tests each with and without the use of a windlass. Without a windlass, improvised tourniquets failed to stop bleeding in 99% of tests (79 of 80 tests). With a windlass, improvised tourniquets failed to stop bleeding in 32% of tests ( p less than .0001). In tests with no windlass, at - tempts to stop the pulse completely failed (100%, 80 of 80 tests). With a windlass, however, attempts to stop the pulse failed 31% of the time (25 of 80 tests); the difference in proportions was significant (p less than .0001). Improvised strap-and-windlass tourniquets were more effective than those with no windlass, as a wind - lass allowed the user to gain mechanical advantage. However, improvised strap-and-windlass tourniquets failed to control hemorrhage in 32% of tests.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2015
- Accession Number
- ADA619853
Entities
People
- James K. Aden 3rd
- John Frederick Kragh
- Matthew P. Altamirano
- Michael A. Dubick
Organizations
- United States Army Institute of Surgical Research