Stretch and Wrap Style Tourniquet Effectiveness With Minimal Training

Abstract

The objective was to determine if proper application of the Stretch, Wrap, and Tuck Tourniquet (SWAT-T) would stop arterial flow and would occur with minimal training. Fifteen undergraduates watched a 19 second video three times, practiced twice, and applied the tourniquet to volunteers at 10 locations: 3 above the elbow or knee and 2 below. Successful occlusion (60 second Doppler signal elimination) was more frequent than proper stretch (96 versus 75), more frequent on arms than legs (59 versus 37), and achieved before completed application (16 +/- 8 versus 33 +/- 8 seconds; each p < 0.05). Proper stretch (correct alteration of shapes printed on the tourniquet) was more frequent on legs than arms (30 versus 45; p <0.05). Applications were rated Easy (101), Challenging (37), Difficult (12) with discomfort None (53), Little (62), Moderate (34), Severe (1). The 8 appliers with <70% proper stretch rates received 10 minutes additional training and then retested at mid upper arm, mid-thigh, and below knee (24 applications) for improved proper stretch and occlusion (5 versus 18 and 10 versus 20; p < 0.01). Proper application of the SWAT-T is easy and can stop extremity arterial flow but requires some training for many appliers.