TMT Tourniquet HOW WE GOT HERE The Tactical Mechanical Tourniquet (TMT™) is a Committee on Tactical Combat Casualty Care-recommended tourniquet, added to the Guidelines in 2019. Our TMT is one of the newest tourniquets to be proposed to the Department of Defense (DoD) since 2005. Other tourniquets currently in production are over 14 years old; a generational change has been long overdue. While tourniquet implementation led to a reduction in the number of deaths from extremity hemorrhage[1], there remains a myriad of limitations to be addressed. View Product WIDER MAKES FOR A BETTER TOURNIQUET The TMT is a major advancement in tourniquet care with its 2″ wide pressure band, resolving issues that profoundly affect the amount of blood loss from extremity hemorrhage. Older tourniquet designs are documented as too narrow to guarantee successful occlusion with the application of only one tourniquet. The TCCC Guidelines, as of August 2018, and the Soldiers Manual of Common Tasks are just a few of the sources that have recommended or reported that a second CAT should be applied when bleeding cannot be controlled using just one[1][2]. To be clear, it is essential to reassess every medical intervention for proper efficacy; however, Safeguard Medical does not believe anyone should routinely need two tourniquets to stop the bleeding of one extremity. Studies have proven a single TMT effectively halts blood flow at a low circumferential pressure due to its two-inch-wide band[3][4]. REFINING THE SOLUTION The Combat Application Tourniquet Versus the Tactical Mechanical Tourniquet; Beaven et al. 2018 “American and British military doctrine advocates the use of two C-A-Ts side by side if bleeding is uncontrolled with one tourniquet. In fact, a real-world study reported the percentage failure of singly applied C-A-T to be 18%, with the thigh being the least successful body region.” “An improvement to the currently used C-A-T would be a device that consistently controlled hemorrhage when used at the mid-thigh level without the need for a paired application. We tested two such devices that we believe can control lower limb hemorrhage when applied singly to the mid-thigh.” “The time to reach complete arterial occlusion was a median of 37.5 (IQR, 27–52) seconds with the C-A-T, and 35 (IQR, 29–42) seconds with the TMT. The 2.5-second difference in median times was not significant (p = .589). The 1-in-10 difference in median pain score also was not significant (p = .656).” “All the study participants had self-applied the C-A-T before during training, and some had applied the C-A-T to other wounded Soldiers, but none had used the TMT before.” Two New Effective Tourniquets for Potential Use in the Military Environment: A Serving Soldier Study; Beaven et al. 2017 “Despite its undeniable successes, the combat applied tourniquet (C-A-T) has some shortfalls, principally its inability to reliably control lower limb bleeding when applied to the mid-thigh.” “Both the tactical mechanical tourniquet and the tactical pneumatic tourniquet demonstrated ability to completely occlude the popliteal artery in 100% of limbs when applied at the mid-thigh level in healthy volunteers. All participants reported acceptable pain scores with both tourniquets. These devices require further investigation to assess their battlefield utility, once this is done, current tourniquet guidelines should be urgently reviewed.” CONFIRMING THE RESULTS The TMT completed the most comprehensive initial field evaluation of any tourniquet in circulation. After successfully completing Phase I through Phase IIIB evaluation by Navy Medical Research Unit San Antonio, 140,000 TMTs were fielded within US Military Units deployed worldwide. This initial fielding is part of our Low Rate Initial Production (LRIP) process. During DoD product development, LRIP is crucial to the Joint Capabilities Integration and Development System (JCIDS) process. Our team at Combat Medical understands this and embraces the extensive fielding and feedback, which is critical to ensure comprehensive LRIP review and validation results. The LRIP feedback resulted in two minor production adjustments: the speed buckle was enhanced to make pulling slack smoother, plus bolstering the windlass retention clip. USER EVALUATIONS: As a culmination of the LRIP process, Combat Medical conducted over 800 end-user surveys following MARCH training to validate its practical design. These user evaluations documented 80.9% positive feedback regarding the TMT’s abilities compared to their issued tourniquet. This aided in creating superior technology that effectively supports the US warfighter in the field. Browse our range of TMT products: TMT Tourniquet TQ RAM INTRODUCING THE TQ-RAM The TQ-RAM is an TMT accessory designed to address wounds not amenable to tourniquet use and as an adjunct to compressible hemorrhage control at the “point of injury”. The TQ-RAM’s innovative and simple design allows for first responders to have an undeniable advantage to provide compression to control difficult bleeds (including in the inguinal area) when attached to the Tactical Mechanical Tourniquet (TMT). The TQ-RAM attaches to the TMT tourniquet carriage plate and can be used over a packed wound, applying additional downward pressure to assist in controlling life threatening hemorrhaging. View Product References: BACKGROUND…HOW WE GOT HERE [1] Eastridge BJ., et al., Death on the battlefield (2001-2011): Implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012 Dec;73(6 Suppl 5):S431-7. DESIGN…WIDER & EASIER MAKE FOR A BETTER TOURNIQUET [1]Committee on Combat Casualty Care, TCCC Guidelines for Medical Personnel. 2018 Aug;2 [2]Soldiers Manual of Common Tasks (SMCT)(STP-21-1- SMCT). (2017). Washington, D.C.: Dept. of the Army, Headquarters. [3]Beaven, Alastair and Rob Briard, et al. “Two New Effective Tourniquets for Potential Use in the Military Environment: A Serving Soldier Study.” Military Medicine (July/Aug 2017): e1929 [4] Naval Medical Research Unit San Antonio, NAMRU-SA REPORT#2015-52 [5]Ochoa J, Danta G, Fowler TJ, Gilliatt RW. Nature of the nerve lesion caused by a pneumatic tourniquet. Nature. 1971 Sept;233:265-6. [6]Piper L. Wall, DVM, PhD et al, Tourniquets and Occlusion: The Pressure of Design, Military Medicine, 178, 5:578, 2013