Best Tourniquet: A Comprehensive Guide to Saving Lives

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Tourniquets are essential lifesaving tools, often used in emergency situations to stop severe bleeding. With numerous types and brands available on the market, it can be challenging to determine the best tourniquet to suit your needs. This comprehensive guide will outline the factors to consider, the top tourniquet options, and tips for proper application.

Table of Contents

Imagine coming across a car accident on a quiet country road. The driver is hurt and has a deep cut on their thigh that’s bleeding heavily.

Usually, you can control bleeding from a regular wound by applying pressure with your hands and bandages. But in this situation, a major artery has been cut, and the driver could lose a lot of blood before help arrives. In cases like car crashes or gunshot wounds, a person can quickly bleed out in just a few minutes. That’s why you need to act fast and do more than just use your hands and bandages. You need a tourniquet.

A tourniquet is a simple device that can stop arterial bleeding from an injured limb within seconds. It works by squeezing the artery shut, similar to pinching a garden hose to stop the water flow. It’s a compact tool that can make a big difference in saving someone’s life.

Having a tourniquet, or even a couple of them, is a crucial component of your emergency toolkit. While many individuals commonly associate respiration and heartbeat as the main concerns during a sudden medical crisis, excessive bleeding, also known as “hemorrhaging,” is another vital aspect that is often overlooked in movies. Shockingly, hemorrhaging accounts for a staggering 60-80% of avoidable fatalities in combat situations. Healthcare professionals highly recommend the CAT-7, priced at $30, and the TacMed SOFTT-W as the most effective tourniquets for emergency preparedness.

These instruments frequently determine the outcome of life and death situations, which is why safety specialists strongly advise carrying at least one in both your bug-out and get-home bags. It may also be wise to have an additional tourniquet among your home supplies. As part of ongoing efforts, organizations like FEMA are actively promoting public awareness and accessibility of tourniquets, leading to a probable increase in their presence alongside defibrillator kits in public locations.

Tourniquets are a staple item in the equipment of first responders and military medics. These professionals, including elite soldiers who prioritize carrying only essential gear while minimizing weight, consistently have a tourniquet at their disposal during combat. In fact, many securely attach their tourniquets to the exterior of their belt, pack, or gear, often using a designated pouch labeled as “TQ,” ensuring swift accessibility and deployment within seconds. The significance of promptly locating tourniquets is unparalleled among medical supplies, making them a vital component in emergency situations.

Crafting a makeshift tourniquet using everyday materials such as cloth and sticks, or even purchasing supplies from a hardware store, is a viable option. However, it is important to recognize that the evidence clearly indicates these improvised methods are significantly less effective in terms of life-saving capabilities.

​​Contemporary tourniquets are reasonably priced, constructed with high quality, and a worthwhile investment for the majority of individuals due to their reliability and ease of use, especially in situations where adrenaline is surging.

Summary:

  1. Ensure you have at least one tourniquet in each of your primary kits: bug-out bag, get-home bag, home supplies, and car kit (if applicable).
  2. Avoid purchasing cheap tourniquets in this category; a $5-15 tourniquet is insufficient. It is more advisable to invest in creating a DIY tourniquet using hardware-store materials instead of wasting money on a substandard product that may fail when needed.
  3. The best tourniquets are priced at $30 and offer durability over time.
  4. Multiple tourniquet styles exist, but the military-approved design is the classic windlass, which involves twisting a solid stick to generate pressure.
  5. Opt for tourniquets with wider cuff surface areas as narrow tubes or straps can be more painful and potentially cause tissue damage.
  6. Regular tourniquets are designed for limbs only. While there are specialized “junctional” tourniquets available for groins and armpits, they are not necessary for most people’s kits.
  7. Tourniquets generally follow a “one size fits most” principle, but they may pose challenges with extremely small or large limbs.

Top Tourniquet Options

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SOFTT-W (Special Operations Forces Tactical Tourniquet – Wide)

 

Price: $30.95

Another top contender, the SOFTT-W is known for its durability and wide strap design. It features a durable aluminum windlass and is suitable for use on both upper and lower limbs.

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SWAT-T (Stretch, Wrap, and Tuck Tourniquet)


Price: $16.08

The SWAT-T is a versatile and cost-effective option, doubling as a pressure dressing when not used as a tourniquet. Its stretchable, latex-free material allows for easy application and adjustment.

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RATS (Rapid Application Tourniquet System)

Price: $94.95

Designed for rapid deployment in high-stress situations, the RATS tourniquet uses a simple, intuitive design. Its compact size makes it ideal for carrying in a pocket or small first aid kit.

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TMT (Tactical Medical Tourniquet)

Price: $25.00

The TMT is a newcomer to the market, boasting an innovative design that aims to address potential issues with other tourniquets. Its dual locking mechanism ensures secure occlusion, while its lightweight construction makes it easy to carry.

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Why We Didn’t Recommend a “Best Budget Tourniquet”

In the world of preparedness, it is often true that you get what you pay for. While it may be tempting to opt for a more affordable tourniquet by sacrificing certain features or quality, this approach is not advisable. We have personally witnessed instances where budget tourniquets, despite receiving positive reviews on online platforms like Amazon, proved to be unreliable in real-life emergency situations.

It is crucial to be aware of the abundance of counterfeit and imitation tourniquets in the market, particularly those attempting to replicate the design of reputable models such as the North American Rescue CAT, which is one of our top recommendations. Tourniquets offered at significantly lower prices, especially below $25, should be approached with caution. Examples of commonly encountered counterfeit tourniquets on platforms like Amazon include Mgrowth and HEPHEAS.

Remarkably, there are Chinese imitations of tourniquets that have replicated the authentic ones so convincingly that they even bear the embossed US patent number on the plastic!

If you find yourself with budget constraints, opting for a DIY approach is a viable alternative. Instead of investing in subpar $15 tourniquets, it is recommended to prioritize acquiring the necessary skills and knowledge. With a visit to a store like Home Depot, you can construct a tourniquet for a mere $5 that surpasses the quality of the inexpensive counterparts.

These makeshift tourniquets can serve as a temporary solution in emergency situations, although they will never match the level of effectiveness and reliability offered by genuine tourniquets.

Qualities We Look for When Reviewing the Best Tourniquets

  • Intuitive: Ease of use even after a long time without practice.
  • Effective: Ability to effectively stop blood flow for average civilians.
  • Durable: Constructed with high-quality materials to withstand pressure and repeated use.
  • Secure: Maintains tightness and position when moving the injured.
  • Meets Medical Standards: Complies with CoTCCC or similar medical standards.
  • One-Handed Application: Can be applied using only one hand.
  • Appropriate Width: Provides a pressure surface area of at least 1.5″ wide to minimize pain and tissue damage.
  • Preference for Windlass-Type Models: Preference for tourniquets with windlass mechanisms.
  • Time Recording: Includes an area/tab to record the time of application, crucial for subsequent medical professionals.
  • Manufactured in Reputable Country: Made in the U.S. or a similarly certified country.

There is a challenging tradeoff in the tourniquet market. Windlass tourniquets are highly effective and usually the quickest to apply, but stretch-and-tuck models are more intuitive due to their simple wrapping motion.

Windlass models tend to be more manageable for one-handed application. On the other hand, applying wrap-and-tuck stretchy band models can be awkward, similar to putting a bracelet on with only one hand.

Tourniquets without a windlass mechanism are at a mechanical disadvantage. It can be significantly more difficult for an average person to generate sufficient pressure around a large, fleshy leg simply by wrapping and tucking stretchy rubber. The windlass provides leverage, similar to using a pulley to lift a heavy object or folding a garden hose in half instead of gripping the tube with your fingers.

The build quality of tourniquets varies greatly. Given their design, tourniquets exert substantial pressure on a few small components for extended periods. A common issue is poorly constructed windlasses that fold under pressure. If the windlass collapses, the tension you created is not sustained, posing a problem.

Medical Standards Matter

The top-notch tourniquets adhere to the standards established by the independent Committee on Tactical Combat Casualty Care (CoTCCC), an organization endorsed by the American College of Surgeons and the National Association of EMTs.

All the tourniquets that we endorse have received approval from the Committee on Tactical Combat Casualty Care (CoTCCC).

In many product categories, being “approved by” a standards body may not hold much significance and can simply result in a higher price. However, when it comes to tourniquets, approval by the relevant standards body is crucial. These medical devices undergo rigorous evaluation in real-life situations, coupled with extensive analysis by professional medics. Testers even employ doppler technology to examine the effectiveness of tourniquets in stopping blood flow within an actual body.

Unfortunately, certain manufacturers have engaged in deceptive practices by creating a for-profit TCCC trademark, allowing them to label their products as “TCCC Approved” without going through the proper certification process. Although this issue was settled out of court in 2016, it’s important to remain vigilant against such unethical tactics.

The Competition

Combat Medical TMT Tactical Mechanical Tourniquet. The TMT tourniquet stands out with its width of two inches, providing a slightly broader coverage compared to the 1.5-inch width of both the CAT and SOFTT-W models. One distinctive feature of the TMT is its torsion bar, referred to as the “windlass,” which incorporates a tactile and audible confirmation to ensure proper securing. Additionally, the TMT utilizes a buckle that locks down to secure the strap, eliminating the need for the velcro attachment.

During our initial testing, we discovered a drawback with the TMT tourniquet. Unlike other models that are not sensitive to the direction of rotation, the TMT requires clockwise rotation of the windlass to consistently secure it in the retention clip. In a self-application scenario, we experienced the unwinding and release of pressure when inadvertently turning the windlass counter-clockwise while attempting to secure it in the retention clip.

SAM XT Extremity Tourniquet. It boasts an auto-locking buckle that assists users in removing any slack from the band. One of the common reasons why windlass-style tourniquets may not achieve desired results is not necessarily due to the materials used, but rather because the circumferential strap is not adequately tightened. The buckle of the SAM XT simplifies the process of achieving a snug fit for the strap and helps maintain its tightness throughout.

The SAM XT tourniquet, similar to the CAT and SOFTT-W, utilizes a metal windlass for its operation. However, unlike the CAT, the SAM XT has a single-piece construction strap instead of a sleeve. While the SAM XT provides smooth and consistent functionality, it is noticeably bulkier in comparison to the CAT and SOFTT-W tourniquets.

m2 RMT Ratcheting Medical Tourniquet, RevMedx TX2, and RevMedx TX3. Manufactured by the same company, M2, the TX2 and TX3 tourniquets are marketed under the brand RevMedX. These tourniquets hold the distinction of being the first ratcheting tourniquets approved by CoTCCC (Committee on Tactical Combat Casualty Care). Although we appreciate the positive mechanism provided by the ratchet, which we believe offers ease of use compared to twisting a windlass, we still maintain some reservations about recommending this particular type of tourniquet.

The material underneath the ratchet tends to gather and doesn’t ensure consistent contact around the entire circumference, leading to increased discomfort. Additionally, none of the new tourniquet models with ratcheting mechanisms allow for true one-handed application. To tighten the tourniquet, you need to utilize the “tactical bite loop” as a counter anchor for the strap.

Although not contenders, we wanted to provide a list of common tourniquets that have not been approved by the Committee or have not applied for approval, so you are aware of their existence:

H&H MET Military Emergency Tourniquet (Gen 3). An alternative type of windlass tourniquet is available, which features a buckle-less design and is deployed as an open loop. To use this tourniquet, the user needs to thread the end through a few sleeves before tightening it. One claimed advantage of this design is that the user does not need to fully tighten the strap before engaging the windlass, unlike tourniquets such as the CAT.

H&H TK-4. The TK-4 tourniquet is a woven elastic band that is 2 inches wide and equipped with two steel hooks on the ends. Although it can be compacted to a small size, the TK-4 is difficult to apply and maintain sufficient pressure to control bleeding, especially in high-stress situations.

PYNG MATCombat / MATResponder. The MAT tourniquet utilizes a “turn-key” system for constriction. The latest generation of this tourniquet addresses issues encountered with the initial version, such as breakage and extreme discomfort for the patient. Please note that as of December 27, 2021, this product has been discontinued.

Recon Medical Tourniquet. Regarded as a replica of the North American Rescue CAT, this tourniquet is not endorsed by the CoTCCC. However, if you are unable to afford the CAT, it serves as a viable budget option and is significantly superior to counterfeit CATs or elastic tourniquets.

Tactical Medical Solutions K9 Tourniquet. The K9 Tourniquet is specifically designed for use on tapered limbs of canines and is not intended for human use. However, some preppers have mistakenly purchased the K9 Tourniquet believing that the CAT or SOFTT-W would not be effective on smaller limbs, such as those of children. In reality, both the CAT and SOFTT-W can be used on canines when properly applied.

Thor TQ. The ratcheting tourniquet in question demonstrates promising potential for one-handed application compared to other models in its category. However, as it is currently unavailable for purchase, we will provide an updated review once we have the opportunity to test and evaluate it firsthand.

Types of Tourniquets

Windlass. Windlass models consist of a loop or sleeve made of webbing that encircles or slides onto a limb, accompanied by a sturdy bar known as the windlass. This windlass can be conveniently grasped, twisted to apply pressure, and secured in position.

In the CAT Gen 7 tourniquet, like many other models, there is a mechanism that secures the windlass bar to prevent it from unwinding. The windlass tip is inserted into one of the two plastic slots. To provide additional security, a velcro tab is then wrapped over the top of the tourniquet.

Ratcheting. Imagine the familiar straps and ratchets typically employed to secure heavy loads on a truck bed. Ratchet tourniquets bear a resemblance to these mechanisms. Some utilize a wind-up drum, akin to truck ratchets, while others adopt a system similar to the commonly used ratchet wrench found in households or the buckles found on ski boots.

In the 2000s, the US Army Rangers tested a ratcheting tourniquet but switched back to the windlass style due to concerns about multiple points of failure. However, modern ratcheting tourniquets have addressed these issues and the first CoTCCC-approved ratcheting tourniquet was introduced in 2019.

Elastic band. Elastic band tourniquets bear a striking resemblance to flat elastic exercise bands or round surgical tubing. Essentially, they are long, stretchy materials that are tightly wrapped around a limb for several rounds. These tourniquets are often referred to as “wrap and tuck” or “stretch” tourniquets, highlighting the method of securing them by wrapping and tightly tucking the ends.

While some individuals argue that elastic tourniquet models are simpler to use compared to windlass models, we have found that this claim holds true mainly in controlled practice scenarios rather than real-life situations. Moreover, when it comes to one-handed operation, windlass tourniquets prove to be less challenging than their elastic counterparts.

When seeking the optimal level of tightness, we favor windlass tourniquets due to their lower risk factor and greater ease in making precise adjustments without the risk of unraveling the entire application.

Pneumatic. Pneumatic models of tourniquets employ an inflatable bladder to exert pressure and restrict blood flow. Interestingly, a familiar example of such a mechanism is the blood pressure cuff commonly used in medical settings. However, pneumatic tourniquets are typically not found outside of hospitals, and we do not recommend them for the average prepper.

Holsters and Storage

Being able to quickly access your tourniquet is crucial in emergency situations. It’s essential to avoid fumbling through a backpack or medical pouch while someone is experiencing rapid and severe bleeding in low-light conditions.

Upon receiving your new tourniquet, it is recommended to remove it from any packaging immediately. Additionally, you might consider refolding the product to ensure it has a flatter profile for more convenient storage.

Since numerous individuals choose to attach the tourniquet to the exterior of their pack or gear, high-quality models often include UV-resistant rubber bands, usually in black color, to ensure they do not deteriorate when exposed to sunlight. It is important not to discard these rubber bands along with the disposable packaging.

Furthermore, it is recommended to consider re-folding the tourniquet to achieve a flatter profile, facilitating more convenient storage.

It is advisable, whenever feasible, to store your tourniquet away from your limbs. While you might come across images of soldiers securing their tourniquets to the front of a shoulder strap on their backpack or body armor, close to the armpit area, it is important to note that if you sustain an injury in the upper arm (one of the few areas where a tourniquet can be effectively applied), you wouldn’t want your tourniquet to be compromised or damaged in the process.

Tips for Proper Tourniquet Application

  1. Familiarize yourself with the tourniquet you have chosen and practice applying it under calm, controlled conditions.
  2. In an emergency, quickly assess the severity of the bleeding and determine if a tourniquet is necessary.
  3. Apply the tourniquet approximately 2-3 inches above the bleeding site, avoiding joints.
  4. Tighten the tourniquet until bleeding stops, ensuring it is secure.
  5. Note the time the tourniquet was applied, as this information is crucial for medical professionals.

Conclusion

Selecting the best tourniquet involves evaluating several factors, such as effectiveness, durability, ease of use, portability, and price. The CAT, SOFTT-W, SWAT-T, RATS, and TMT are all viable options, each with their unique features. By familiarizing yourself with the tourniquet you choose and practicing proper application, you will be better prepared to save a life in an emergency situation.

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