{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:15:03Z","timestamp":1774581303320,"version":"3.50.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Alexander Grass Fund for Research in Military Medicine of the Faculty of Medicine"},{"DOI":"10.13039\/501100003483","name":"Hebrew University of Jerusalem","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tourniquet application is an urgent life-saving procedure. Previous studies demonstrated several drawbacks in tourniquet design and application methods that limit their efficacy; among them, loose application of the device before windlass twisting is a main pitfall. A new generation of modern combat tourniquets was developed to overcome these pitfalls. The objective of this study was to assess the effectiveness of three new tourniquet designs: the CAT Generation 7 (CAT7), the SAM Extremity Tourniquet (SAM-XT), and the SOF Tactical Tourniquet Wide (SOFTT-W) as well as its correlation to the degree of slack.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The three tourniquet models were applied in a randomized sequence on a HapMed leg tourniquet trainer, simulating an above-the-knee traumatic amputation by 60 military medicine track cadets. Applied pressure, hemorrhage control status, time until the bleeding stopped, estimated blood volume loss, and slack were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean (\u00b1SD) pressure applied using the SAM-XT (186\u00a0mmHg \u00b163) or the CAT7 (175\u00a0mmHg \u00b179) was significantly higher compared to the pressure applied by the SOFTT-W (104\u00a0mmHg \u00b1101, P\u00a0&amp;lt;\u00a00.017), with no significant difference between the first two (P\u00a0&amp;gt;\u00a00.05). Hemorrhage control rate was similar (P\u00a0&amp;gt;\u00a00.05) with SAM-XT (73.3%) and CAT7 (67.7%), and both were significantly better than the SOFTT-W (35%, P\u00a0&amp;lt;\u00a00.017). Slack was similar between CAT7 and SAM-XT (5.2\u00a0mm\u00a0\u00b1\u00a03.4 vs. 5\u00a0mm\u00a0\u00b1\u00a03.5, P\u00a0&amp;gt;\u00a00.05), yet significantly lower compared to the SOFTT-W (9\u00a0mm\u00a0\u00b1\u00a05, P\u00a0&amp;lt;\u00a00.017). A strong negative correlation was found between slack and hemorrhage control rate (3.2\u00a0mm\u00a0\u00b1\u00a01.5\u00a0mm in success vs. 10.5\u00a0mm\u00a0\u00b1\u00a03.4\u00a0mm in failure, P\u00a0&amp;lt;\u00a00.001) and applied pressure (Pearson\u2019s correlation coefficient of \u22120.83, P\u00a0&amp;lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both SAM-XT and CAT7 demonstrated a better pressure profile and hemorrhage control rate compared to SOFTT-W, with no significant difference between the two. The better outcome measures were strongly correlated to less slack.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usz392","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T14:59:39Z","timestamp":1582556379000},"page":"e377-e382","source":"Crossref","is-referenced-by-count":7,"title":["Assessing the Current Generation of Tourniquets"],"prefix":"10.1093","volume":"185","author":[{"given":"Shimon","family":"Katsnelson","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Institute for Research in Military Medicine, The Hebrew University of Jerusalem and Israel Defense Forces Medical Corps, POB 12272, Jerusalem 91120, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessie","family":"Oppenheimer","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Institute for Research in Military Medicine, The Hebrew University of Jerusalem and Israel Defense Forces Medical Corps, POB 12272, Jerusalem 91120, 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