1. Must Stop Arterial Bleeding in Lower Extremities
· Must be 100% effective in clinical environment
· Must account for large girth lower extremities (95% male soldier=26.7")
2. Optimal Design: Pneumatic Cuff
Note: USAISR and historical studies show pneumatic device superiority because of the manner in which they distribute force evenly over a wider area, making them suitable for surgical procedures. Only the Delphi EMT received recommendations by the USAISR due to its ability to be secured by a clamp; surgical tourniquets were considered too expensive.
Advantages:
· Creates even pressure distribution over wider area
· Pressure can be easily measured
· Lower incidence of comorbidity; lower shear stress forces along edges
Disadvantages:
· Difficult to ruggedize for austere environment (shelf life, puncture, leaks)
· Larger/heavier
· Expensive
3. Temporary Tactical Tourniquets
· Width > 1"
· Integrated mechanical augmentation (windlass, ratchet, cam)
· Easily applied to upper or lower extremity (in less than one minute)
· No external power requirement (batteries)
· Light weight (< 230 g) and minimal cube space (facilitates individual carry)
· Easy to train
· Must not slip during application
· Must have easy release and reapplication capability
· Must prevent accidental release
· Long shelf/storage life
4. Other Considerations
· Can be applied to entrapped limbs
· Can be self-applied with one hand
· Protection from over-tightening
· Expense
