Role of the Windlass in Improvised Tourniquet Use on a Manikin Hemorrhage Model
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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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.
- Anatomy and Physiology
- Medicine and Medical Research
- Medical Facilities, Equipment and Supplies