Analysis of tourniquet pressure over military winter clothing and a short review of combat casualty care in cold weather warfare

ABSTRACTCold weather warfare is of increasing importance. Haemorrhage is the most common preventable cause of death in military conflicts. We analysed the pressure of the Combat Application Tourniquet® Generation 7 (CAT), the SAM® Extremity Tourniquet (SAMXT) and the SOF® Tactical Tourniquet Wide Ge...

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Bibliographic Details
Published in:International Journal of Circumpolar Health
Main Authors: Raimund Lechner, Yannick Beres, Amelie Oberst, Kristina Bank, Markus Tannheimer, Martin Kulla, Bjoern Hossfeld
Format: Article in Journal/Newspaper
Language:English
Published: Taylor & Francis Group 2023
Subjects:
Tactical Combat Casualty Care
arctic warfare
hemostatic dressing
hypothermia
critical bleeding
cold weather warfare
Arctic medicine. Tropical medicine
RC955-962
Arctic
Circumpolar Health
International Journal of Circumpolar Health
Online Access:https://doi.org/10.1080/22423982.2023.2194141
https://doaj.org/article/d8aa15e1e6cd4ce59e28f02f81ade8c1
Description
Summary:ABSTRACTCold weather warfare is of increasing importance. Haemorrhage is the most common preventable cause of death in military conflicts. We analysed the pressure of the Combat Application Tourniquet® Generation 7 (CAT), the SAM® Extremity Tourniquet (SAMXT) and the SOF® Tactical Tourniquet Wide Generation 4 (SOFTT) over different military cold weather clothing setups with a leg tourniquet trainer. We conducted a selective PubMed search and supplemented this with own experiences in cold weather medicine. The CAT and the SAMXT both reached the cut off value of 180mmHg in almost all applications. The SOFTT was unable to reach the 180mmHg limit in less than 50% of all applications in some clothing setups. We outline the influence of cold during military operations by presenting differences between military and civilian cold exposure. We propose a classification of winter warfare and identify caveats and alterations of Tactical Combat Casualty Care in cold weather warfare, with a special focus on control of bleeding. The application of tourniquets over military winter clothing is successful in principle, but effectiveness may vary for different tourniquet models. Soldiers are more affected and impaired by cold than civilians. Military commanders must be made aware of medical alterations in cold weather warfare.

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