Tourniquets revisited for 2016 - CAT, SOFTT-W or SWAT-T

As a professional firearms instructor, I have relied on the experience and professionalism of this forum a LOT. I am no means a trained medic, but I read a lot; research extensively before I recommend anything, and talk to as many professionals as I can.

I am also a natural-born cynic and can spot a fake review for a product from a mile away. Growing up during the Cuban missile crisis, I guess you could also say I am a good example of why one should sometimes - to paraphrase an old adage - listen to the old man in a young person's game.

As one who would like to see an IFAK on the belt or person of every law enforcement officer in the nation (among others) I am a strong advocate for minimal kits on the person instead of extensive kits 100 meters away. This is why I am coming to this forum to ask questions about tourniquets and perhaps spark some discussions amongst some very knowledgeable folks.

I have seen pictures of the SWAT-T, but never tried it myself. I know and trust the CAT and the SOF-TT wide. (I currently have two CATs: one in my IFAK and a second one in my vehicle.)

Quite frankly, when I first saw the SWAT-T, I was less than impressed. I have now read many reviews, pro and con, and have come away even less impressed than before. Does anyone have any real life experience with the SWAT-T?

My initial reviews were that it was compact (and certainly better than nothing) but I don't know if I could trust it to work reliably in the field under fire, and while transporting a subject out of the fire zone. Reading the reviews, I found two extremes. Casual users seemed to like its cheap cost and size; medical professionals seemed to hate it. I also found evidence of a lot of fake reviews, possibly from suppliers or manufacturer.

Even more disturbing was reviewers not just talking about the advantages of the SWAT-T stretch-wrap-tuck design, but openly criticizing the CAT. So my next question is, does anyone have any real world experience of a CAT actually failing?

I don't mean to disparage the SWAT-T before I have even tried it myself. What turned me off was the name - trying to piggyback on the reputation of the SOF-T perhaps? - and the cost. I don't buy things that are cheap; I buy things that WORK.

We tried some in an EMT refresher course. One broke on me, albeit on the second or third application as we were self applying. Basically four inches fell off of the big rubber band, which still left it partially useable.

I would rate closer to gimmick than gold, but better than nothing. YMMV.

I carry the SOF-T in my Medical bag and on my vest. Never had to use them but I figure, for a civilian, they came highly recommended and will likely perform better than a shoelace.

Sorry I have no experience with the SWAT-T.

ETA: Granted not many civilians have vests or L4 ceramic plates either, so I am likely an oddity.

Granted I have no real experience in these matters but what I have observed when looking at personal and premade ifaks etc is that the swat-t is only really chosen when going for a minimalist or slim kit.

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Originally Posted by Chickenhawks

So my next question is, does anyone have any real world experience of a CAT actually failing?

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Check out this thread for my experience with wear and failure patterns for the CAT and SOFTT-W. (That's not a "use the search function", just a handy thread.)
https://www.m4carbine.net/showthread...(Update-12-26)

Use the most current CAT (gen 7) if you go that route.

I like the elastic tourniquets for peds TQs and pressure dressings. They are an option for packaging in spaces where a windlass TQ like the CAT or SOFTT-W won't fit. They work for hem control, but they are harder to self apply one handed, in irregular positions, with bloody hands. More variables combined, more quirks.

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Originally Posted by ST911

Check out this thread for my experience with wear and failure patterns for the CAT and SOFTT-W. (That's not a "use the search function", just a handy thread.)
https://www.m4carbine.net/showthread...(Update-12-26)

Use the most current CAT (gen 7) if you go that route.

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Oh, trust me; I have read your thread! I agree 100% with what you say in there. Personally, I have an orange CAT in an IFAK and a black CAT in a vehicle kit. (No particular reason for the choice of colours, other than perhaps the orange matches the blaze orange paracord that I replaced all my zipper pulls with on my IFAK.)

I use a blue one exclusively for training.

I have and carry both a SWAT-T as well as the Gen 7 CAT on duty in a professional environment (Police and Public Safety). As you know, there are pros and cons to each. I like the SWAT for the size and versatility and the CAT for ease of use and reliability. Where the SWAT-T can really excel is as a secondary TQ or as a pressure dressing. While not completely ideal as a standalone TQ it does work if applied correctly and is better than nothing.. It is also better for children. If its all you can carry, carry it. It does have it's quirks but I think the price reflects that and I'd choose a SWAT-T long before a similarly priced CAT knockoff. Our FD also carries them on the rig and on their plate carriers (yes).

TL;DR

SWAT-T for minimalism, price and versatility

CAT 7 for reliability, ease of use and pretty much everything else.

Quote:

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Originally Posted by ST911

Check out this thread for my experience with wear and failure patterns for the CAT and SOFTT-W. (That's not a "use the search function", just a handy thread.)
https://www.m4carbine.net/showthread...(Update-12-26)

Use the most current CAT (gen 7) if you go that route.

I like the elastic tourniquets for peds TQs and pressure dressings. They are an option for packaging in spaces where a windlass TQ like the CAT or SOFTT-W won't fit. They work for hem control, but they are harder to self apply one handed, in irregular positions, with bloody hands. More variables combined, more quirks.

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Thank you for taking time to write up the original post and then following up with this one. I was looking at the SOFTT, and that metal buckle - that looked like it might be more difficult to get latched with bloody hands and adrenaline pumping (shaky hands). When you refer to the "elastic tourniquet's" are you talking about the RAT? I haven't seen any of them out in anyone's kit, but I'm not a medic either.

I don't think I own any Gen 7's. Most of mine are still within exp. date, but honestly, I do not know what version they are. can you clarify "peds TQ"?
Thanks!

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Originally Posted by RobertTheTexan

Thank you for taking time to write up the original post and then following up with this one. I was looking at the SOFTT, and that metal buckle - that looked like it might be more difficult to get latched with bloody hands and adrenaline pumping (shaky hands). When you refer to the "elastic tourniquet's" are you talking about the RAT? I haven't seen any of them out in anyone's kit, but I'm not a medic either.

I don't think I own any Gen 7's. Most of mine are still within exp. date, but honestly, I do not know what version they are. can you clarify "peds TQ"?
Thanks!

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Doesn't really matter what generation it is as long as it's not ancient. Gen 7's are just beefier and less prone to breakage.

Peds=Pediatric AKA Minor/Infant/Youth

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Originally Posted by tacticaldesire

Doesn't really matter what generation it is as long as it's not ancient. Gen 7's are just beefier and less prone to breakage.

Peds=Pediatric AKA Minor/Infant/Youth

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Thanks TD. I suspected it meant pediatric, but I've almost been wrong as rain enough times to just ask. Thanks for the input on the CATs. I do have some older ones that expired in 2005-2008, I do use those to train with but the ones I know haven't been exposed to a lot of heat or used are backups to my backup.


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Quote:

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Originally Posted by RobertTheTexan

I was looking at the SOFTT, and that metal buckle - that looked like it might be more difficult to get latched with bloody hands and adrenaline pumping (shaky hands).

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In a word, no. It has its own particulars, but there are some things about it that mitigate them too. I also recommend working that buckle a number of times when the TQ is new to make the process a little smoother.

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When you refer to the "elastic tourniquet's" are you talking about the RAT? I haven't seen any of them out in anyone's kit, but I'm not a medic either.

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Yes, SWAT-T, TK4, RATS, and any others similarly constructed.

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I don't think I own any Gen 7's. Most of mine are still within exp. date, but honestly, I do not know what version they are. can you clarify "peds TQ"?
Thanks!

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Pediatric use, or small diameter limb that a CAT or SOFTT-W won't close enough around to compress. I have had some IBOs that couldn't use a SOFTT-W or CAT.

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Originally Posted by tacticaldesire

Doesn't really matter what generation it is as long as it's not ancient. Gen 7's are just beefier and less prone to breakage.

Peds=Pediatric AKA Minor/Infant/Youth

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This. Newer CATs (as of gen 5 or so?) are also longer, which is helpful for beefier folks.

The Cat and Softt-w are superior for use as a primary tourniquet especially for self aid. I was a big fan of the soft-w, but am liking the Gen 7 CAT more and more - there is so much personal preference when in comes to those 2,you can't go wrong with either one

The swat T is great to have as a backup - it works on K9 and very small people/ children where a CAT/Sofft may not work. It also doubles as a back up pressure dressing and wrap. It's small enough to add to most kits and not be In the way. It can be used for self aid, but is much more awkward when compared to the cat/softt-w.

All TQs have a finite life span and breaking points when used in training - that's why it's not recommended to use your " real" TQ for training.

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Originally Posted by ST911

In a word, no. It has its own particulars, but there are some things about it that mitigate them too. I also recommend working that buckle a number of times when the TQ is new to make the process a little smoother.



Yes, SWAT-T, TK4, RATS, and any others similarly constructed.



Pediatric use, or small diameter limb that a CAT or SOFTT-W won't close enough around to compress. I have had some IBOs that couldn't use a SOFTT-W or CAT.



This. Newer CATs (as of gen 5 or so?) are also longer, which is helpful for beefier folks.

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It's been two weeks in coming, but a big Thank You! For answering all my questions TC. I thought we had mastered acronyms in the MI field, but you medic types have your own language altogether! ;-)


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I generally EDC a Gen 7 CAT in an Eleven 10 TQ holster. It can be IWB, but it's a bit bulky and the velcro can rub the wrong way if you don't have an undershirt. I've really only tried to practice with the SWAT/SOFT-W a couple of times, but as a non-medical/tactical professional with limited hard drive space, the CAT has proven to be the easiest, most reliable, and self-applicable TQ I've used. It's not the lightest or smallest, but I have a trainer CAT I can apply one handed with either hand, and it's simple and effective (the Gen 7 being even easier).

On a side note, EDCing a CAT, I've been stopped by security in some sensitive places and then subsequently searched for weapons, so you do have to be careful; wearing cargo pants and EDCing a CAT definitely makes you stick out like a sore thumb and can lead to unwanted attention. Cargo pants aren't terribly low-pro or grey man, but it's my personal choice anyway.

My go to are the CAT and SOF-T.

I like the CAT for self application, one handed application. The SOF-T is durable, robust and has no expiration date. Both are top notch and the only ones typically recommended repeatedly in multiple TCCC and TEMS courses attended.

I came across this TQ on uncrate: http://samxt.com/

Has anyone come across the Sam XT?

https://photos-4.dropbox.com/t/2/AAB...36&size_mode=3

It's very new. It is listed as available on Boundtree. I've been waiting on a reviewer I follow online to give feedback.

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Originally Posted by contax_shooter

I came across this TQ on uncrate: http://samxt.com/

Has anyone come across the Sam XT?

https://photos-4.dropbox.com/t/2/AAB...36&size_mode=3

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It is brand new and I don't think many people have their hands on them, and if they do, there's likely an NDA because there's not a ton out there on it yet.

I have had a SAM XT for a while now. It is very CAT like in operation. The buckle used to take the initial slack out works well- anyone who has used their pelvic sling or Junctional TQ will be familiar with how the buckle works
The design is pretty good in taking the slack out and requiring minimal twist of the windlass to occlude blood flow
It's a fairly easy learning curve as well.

We carry the CAT on our helicopter and the local EMS/FD carry them as well. We have been having great success with them. I also carry a CAT and a SWAT-T in my flight suit. As has been mentioned the CAT is easy to self apply than the SWAT-T so the CAT would be my primary for myself. I have not used a SWAT-T as a tourniquet yet, but have used it as a pressure dressing and it worked well in that role. One of our trauma physicians who is also the medical director for the State Trooper's SWAT and air rescue teams has had great luck with the SWAT-T in the trauma unit, but also prefers the CAT if you only carry one TQ.

I will have to add SAM XT to the list!

I just received my SAM XT (Extremity Tourniquet) today. I immediately opened the packaging and put it to the test against some of the others.

First test was to apply it to myself without reading instructions. It goes on very quickly, even one-handed. The plastic buckle clicks in place when it wraps sufficiently tight and the windlass needs only minimal turns to tighten from there. That's it. It actually seemed too simple.

First impressions are that it is very well made. It comes from SAM Medical Design of Wilsonville OR; the same company who manufactures other emergency medical products such as the SAM Junctional Tourniquet, SAM splint and SAM chest seal. It is hard to determine the quality of products such as this based just on photos, so I was more than favorably impressed when I got it out of the package. The velcro is high quality, the plastic appears to be high impact polymer, the windlass nylon is wide and the windlass rod is metal. I thought the holes might be a weak point in the design but that proved not to be the case. The strap is VERY strong.

When I first put it on myself, i was initially confused because of how simple it is to apply. You wrap it around your arm or leg, loop the strap through the wide opening of the plastic buckle and pull it back on itself. It automatically clicks into place when the correct tension is reached.

I actually had to read the instructions to make sure I wasn't missing anything. Just playing with it and feeding the strap through the buckle actually seemed TOO easy. What I didn't realize until I actually put it around my leg for real is that the pins will protrude through the spring-loaded buckle and lock it into place automatically when the correct tension is reached. It takes less time to apply than it does to read the previous sentence.

All it takes after the strap is tight is a few turns of the windlass, and it is applied.

The release is equally intuitive; one simply pulls up on the buckle at the tab. On my first test, I tried to get it to release accidentally, but could not. Even with the loose end dangling and not looped back on itself, the buckle would not accidentally release while under tension.

A tourniquet will cause pain when applied properly (and after it is released) so I admit I only left it on for a few seconds and didn't tighten the windlass all the way. (Further tests will follow.) But I can still feel it in my leg and my arm an hour after it was applied, even for those only few seconds on each.

Further tests planned will be locking under tension after cold soaking it at minus 20 degrees Celsius, heating it to 40 degrees C, soaking it in water overnight and burying it in mud to see if it locks automatically without cleaning. Just for fun, I will then test it to destruction just to see what kind of tension it can withstand. The practical application of this final test may not be entirely clear, but I have two anyway so I might as well see what it takes to break either the strap or the buckle.

I am a huge fan of the CAT tourniquet, and have one in each color. (No, it's not to coordinate with my various outfits. The blue one is dedicated to training purposes.) The SAM XT comes in black and orange and there is no blue version, but I would highly recommend one unwrap their new SAM XT and try it out once or twice. There probably isn't as much need for a specially-colored training version, simply because it is so simple to understand and easy to apply that five minutes will be all the training anyone will ever need.

SAM Medical recommends it be discarded after actual use, and as with any tourniquet used for training and not just a few trial fittings, one should not trust it for field use afterwards.

Overall, I like it. Let's see what it takes to break this, and it will take a lot to push the CAT off the top of my personal list, but so far, I am impressed.

Quote:

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Originally Posted by Chickenhawks

I will have to add SAM XT to the list!

I just received my SAM XT (Extremity Tourniquet) today. I immediately opened the packaging and put it to the test against some of the others.

First test was to apply it to myself without reading instructions. It goes on very quickly, even one-handed. The plastic buckle clicks in place when it wraps sufficiently tight and the windlass needs only minimal turns to tighten from there. That's it. It actually seemed too simple.

First impressions are that it is very well made. It comes from SAM Medical Design of Wilsonville OR; the same company who manufactures other emergency medical products such as the SAM Junctional Tourniquet, SAM splint and SAM chest seal. It is hard to determine the quality of products such as this based just on photos, so I was more than favorably impressed when I got it out of the package. The velcro is high quality, the plastic appears to be high impact polymer, the windlass nylon is wide and the windlass rod is metal. I thought the holes might be a weak point in the design but that proved not to be the case. The strap is VERY strong.

When I first put it on myself, i was initially confused because of how simple it is to apply. You wrap it around your arm or leg, loop the strap through the wide opening of the plastic buckle and pull it back on itself. It automatically clicks into place when the correct tension is reached.

I actually had to read the instructions to make sure I wasn't missing anything. Just playing with it and feeding the strap through the buckle actually seemed TOO easy. What I didn't realize until I actually put it around my leg for real is that the pins will protrude through the spring-loaded buckle and lock it into place automatically when the correct tension is reached. It takes less time to apply than it does to read the previous sentence.

All it takes after the strap is tight is a few turns of the windlass, and it is applied.

The release is equally intuitive; one simply pulls up on the buckle at the tab. On my first test, I tried to get it to release accidentally, but could not. Even with the loose end dangling and not looped back on itself, the buckle would not accidentally release while under tension.

A tourniquet will cause pain when applied properly (and after it is released) so I admit I only left it on for a few seconds and didn't tighten the windlass all the way. (Further tests will follow.) But I can still feel it in my leg and my arm an hour after it was applied, even for those only few seconds on each.

Further tests planned will be locking under tension after cold soaking it at minus 20 degrees Celsius, heating it to 40 degrees C, soaking it in water overnight and burying it in mud to see if it locks automatically without cleaning. Just for fun, I will then test it to destruction just to see what kind of tension it can withstand. The practical application of this final test may not be entirely clear, but I have two anyway so I might as well see what it takes to break either the strap or the buckle.

I am a huge fan of the CAT tourniquet, and have one in each color. (No, it's not to coordinate with my various outfits. The blue one is dedicated to training purposes.) The SAM XT comes in black and orange and there is no blue version, but I would highly recommend one unwrap their new SAM XT and try it out once or twice. There probably isn't as much need for a specially-colored training version, simply because it is so simple to understand and easy to apply that five minutes will be all the training anyone will ever need.

SAM Medical recommends it be discarded after actual use, and as with any tourniquet used for training and not just a few trial fittings, one should not trust it for field use afterwards.

Overall, I like it. Let's see what it takes to break this, and it will take a lot to push the CAT off the top of my personal list, but so far, I am impressed.

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Thanks for the review! I put one in my cart last week, then took it out and bought another SOFT T W since I am familiar. Good to know about the SAM XT for future though.

Here are the results of further testing of the SAM XT.

I tested it in very cold and very hot conditions, and it worked just fine. I submerged it in mud for two days. No problem. I poured fine dust on it. No problem. I soaked mosquito repellant containing DEET on the strap and buckle - one of the tests that separate NATO Stanag tests from the easier Mil-Spec tests of firearms and accessories - and found no problem.

Confession. I got so bored with testing this thing that I decided to break it.

There is no way I could test this on a human being because the pain it would cause when tightened far beyond its design intent would be extreme. I suspect even a dummy would complain. So I wrapped it around my hydraulic 3-ton floor jack that I happened to have sitting around from changing out the winter tires on my SUV. I jacked it up about 8 inches so it would be near the end of the strap travel, wrapped it tight until it clicked, and laid the remaining 6 inch tongue along the velcro strap. I then over-torqued the windlass far beyond what anyone would require to stop the blood flow. No breakage.

I then cranked up the jack to about 14 inches high. The velcro screamed a bit in protest but it never came apart. I actually used the same strength as what I used to crank up one corner of a full-size SUV, and the damn thing wouldn't break. It wouldn't even come apart.

In fact, it was still in good enough shape to use for training purposes.

This is a very impressive performance. I would guess I cranked that jack to at least several tons of pressure, and nothing broke or came apart.

While I have never tested a CAT the same way, I suspect it would preform similarly. Maybe someone else can take an old CAT or SOF-T wide and see if they can break it in a hydraulic floor jack. The practical application of this test is pretty much nil because the potential breaking strength of a good tourniquet would be hundreds of times more than necessary to stop blood flow.

But, wow, was that impressive. I am not throwing away my CATs, but the SAM XT is my new go-to TQ, and one I can now comfortably recommend to anyone who asks.

Anyone else wanna have some fun and see what it takes to break these things?

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Originally Posted by Chickenhawks

Here are the results of further testing of the SAM XT.

I tested it in very cold and very hot conditions, and it worked just fine. I submerged it in mud for two days. No problem. I poured fine dust on it. No problem. I soaked mosquito repellant containing DEET on the strap and buckle - one of the tests that separate NATO Stanag tests from the easier Mil-Spec tests of firearms and accessories - and found no problem.

Confession. I got so bored with testing this thing that I decided to break it.

There is no way I could test this on a human being because the pain it would cause when tightened far beyond its design intent would be extreme. I suspect even a dummy would complain. So I wrapped it around my hydraulic 3-ton floor jack that I happened to have sitting around from changing out the winter tires on my SUV. I jacked it up about 8 inches so it would be near the end of the strap travel, wrapped it tight until it clicked, and laid the remaining 6 inch tongue along the velcro strap. I then over-torqued the windlass far beyond what anyone would require to stop the blood flow. No breakage.

I then cranked up the jack to about 14 inches high. The velcro screamed a bit in protest but it never came apart. I actually used the same strength as what I used to crank up one corner of a full-size SUV, and the damn thing wouldn't break. It wouldn't even come apart.

In fact, it was still in good enough shape to use for training purposes.

This is a very impressive performance. I would guess I cranked that jack to at least several tons of pressure, and nothing broke or came apart.

While I have never tested a CAT the same way, I suspect it would preform similarly. Maybe someone else can take an old CAT or SOF-T wide and see if they can break it in a hydraulic floor jack. The practical application of this test is pretty much nil because the potential breaking strength of a good tourniquet would be hundreds of times more than necessary to stop blood flow.

But, wow, was that impressive. I am not throwing away my CATs, but the SAM XT is my new go-to TQ, and one I can now comfortably recommend to anyone who asks.

Anyone else wanna have some fun and see what it takes to break these things?

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Very cool. Thanks for posting your results. I am going to pick one up to check out.

Let me know what you think.

I am working on a magazine article on the latest technology and techniques. The field of combat medicine is ever evolving, and what I said four years ago, may not apply as equally today.