The SWAT Tourniquet

SWAT Tourniquet, atop US Army IFAK

The essential element of bleed management in the tactical setting is the tourniquet. It is not ideally a stand alone tool, but in many ways it remains the tool. If no other tool is available, a tourniquet can be placed with life saving effect. Even when other tools are available, tourniquet placement on active extremity hemorrhage can mean the difference between a patient surviving to the point of further management and not. Tourniquets are the tool a fighter can apply rapidly and quickly, with a high level of certainty that blood loss will at least be reduced, and return to the fight after doing so.

What It Is:
There are a bevy of “tactical” tourniquets on the modern market. Primarily one hand designs, as necessitated by the realities of self care and the tactical environment, but of all shapes, materials and sizes. Many of them are overly complex, and yet others are absolutely simple.
Of the available options, it probably doesn’t get simpler than the Stretch, Wrap And Tuck Tourniquet (SWAT-T) from TEMS Solutions. The SWAT-T is absolutely minimalist design at its finest and most functional, being a simple band of latex-free rubber approximately 4-feet long, and 4 inches wide. Simple as it is, when properly applied the SWAT-T can deliver complete tourniquation of even larger limbs (muscular legs at the thigh).

SWAT Tourniquet Unfurled

To use the SWAT-T as a tourniquet, it must be wrapped around the limb (proximal placement, standard application for any tourniquet) under tension. Pulling the SWAT-T, stretching the material constantly as it is wrapped, allows it to be wrapped extremely tightly. Once wrapped, to secure it, you simply lift an edge of the material and tuck the running end firmly under. The material, being somewhat self adhering, pulls down against itself as it tries to relax into its unstretched state. This both locks the running end firmly in place, and pulls the tourniquet even tighter on the limb. Application is fast, secure, and effective.

SWAT Tourniquet Self-Applied to Upper Arm

On the SWAT Tourniquet website, www.SwatTourniquet.com, several videos of it being applied are posted. In each video, vascular Doppler is used to measure flow (or, lack of flow as the case is) after application. The flow in both leg and arm applications is completely occluded. This has been duplicated in independent review posted by a moderator on the Professional Soldiers board, and quoted in a Powerpoint issued by SWAT Tourniquet.
In addition to functioning as a tourniquet, the SWAT-T can function as pressure dressing, elastic wrap or in an emergency splinting role. The tourniquet is printed with a series of directions and simple symbols, indicating when it is stretched enough to provide the proper amount of pressure for effective tourniquation. When applying it for other purposes, you simply don’t stretch it as much. The visual indicators on the tourniquet are a very effective guide for applying it correctly.
The developer has reported that those unfamiliar with the SWAT-T, upon being handed it and looking at the instructions, take an average of around twenty seconds to successfully apply it. Given its intuitive simplicity, clear packaging instructions and on-board visual feedback, this should be no surprise.




Our Experience:
I first became aware of the SWAT-T in the late summer of 2008, when it was posted on Total Protection Interactive by another staffer. At the time, I ordered a couple and dropped a note to the company owner and developer complimenting him on the elegant simplicity of his product. After swapping a few emails, he sent along a few additional SWAT-T’s for my training group to work with.
My regular training group and I broke them out over an evening bullshit session, and the three of us took turns applying one of the tourniquets. As has been shown elsewhere, we picked it up very quickly and were getting repeatable, consistent results even with one-hand application very quickly. In the following weeks, we spent part of several training sessions working with the SWAT-T. Before long all of us had started running SWAT Tourniquets in our personal blow-out kits.

On the Range with the SWAT Tourniquet

We had repeatedly used one SWAT-T in particular, and I was carrying it loose in a bag with other training gear. One evening while demoing it to someone I noticed a small, less than one inch, tear in the side of the tourniquet. It is my assumption that the tear occurred not from repeated use, but from being carried loose and incurring damage from the sharp edge of something in the bag. I noticed the tear after successfully applying the SWAT-T to my thigh. I took the tourniquet off, and reapplied it to my upper arm, and while doing this it went ahead and tore through at the tear. A roughly ten inch section of the tourniquet was torn free, leaving just over three feet in the largest piece. I used this three foot section to finish wrapping my bicep, and achieved successful occlusion of the blood flow (measured via radial pulse, as I don’t have access to sexy Doppler equipment). Taking this section of the SWAT-T from my bicep, I then applied it to my upper thigh (approximately thirty inches around). I was able to achieve enough reduction in blood flow to numb the leg, and make the pedal pulse undetectable. While this may not be enough to achieve complete occlusion, it would at least be some reduction in blood flow, making further management such as hemostatic and pressure dressing applications possible. Many tourniquets, when damaged like that, would be rendered useless. The SWAT-T retains a high degree of functionality when damaged.

The Torn SWAT Tourniquet

I want to stress that the damage I experienced was not from repeated stressing of the material, but from rough handling. The material in the SWAT Tourniquet is extremely tough and durable. TEMS Solutions has put the material through extensive repeated load testing, to include more than five-thousand cycles at 250% strain, heating to three-hundred degrees Fahrenheit, boiling and freezing. The SWAT Tourniquet passed these tests with aplomb. I personally froze, boiled and over-stretched a single SWAT Tourniquet, not the one that “failed”, and suffered no detriments. The biggest failure risk to the SWAT Tourniquet is not prior use in training or practice, but environmental damage.
Considering that many tourniquets are carried outside the blow-out kit pouch, on the surface of armor carriers and load bearing equipment, the possibility for damage is high. The SWAT-T, given that it is rubber, may have a higher possibility of incurring incidental damage during carry, but also has a higher likelihood of being somewhat useable afterwards as well. ProMed Kits makes a MOLLE compatible tourniquet pouch out of Cordura, designed specifically for the SWAT Tourniquet. Other small pouches, such as the County Comm PCC pouch, and possibly glove pouches, would probably fit the folded SWAT-T as well. I’ve recommended that everyone in my group and classes keep the SWAT Tourniquet in its original ziplock packaging, or acquire a small pouch that fits to protect it from environmental damage during carry.

Our initial evaluations of the SWAT Tourniquet were during the period when I was developing the class Self Care in the Tactical Environment, and my group and I decided to use the SWAT Tourniquet as the tourniquet around which the class recommended blow-out kit was built. Resultantly the SWAT-T was a focus of the tourniquet instructional segment, and of the practical drills. While I am a fan of several larger mechanical tourniquets, and developed my teaching model to incorporate just about every available option from improvisation to the latest and greatest, the SWAT Tourniquet just met the needs of the class better. Focusing on self care in the civilian, or otherwise isolated, environment in which load bearing is minimal due to street clothes, the SWAT-T was an ideal solution. The more I carried the tourniquet on a daily basis, and worked with it independently and with my group, the more convinced of its utility for this role I became.
When the first class was finally held, we had SWAT Tourniquets available for each student, and they were very well received. Everyone picked up the idea very quickly, and were getting successful applications after just a few seconds of instruction, usually on their first attempt. Everyone was impressed with the compactness, simplicity and effectiveness of the tourniquet.

A Student Demonstrating a Complete Penetrating-Injury Management: SWAT Tourniquet in place, Wound packed with Combat Gauze, secured with Israeli Dressing, and Hemostatic package fastened for obvious identification by responders.

One thing I had noticed, and commented on with my group that students reflected was the relative painlessness of applying the SWAT-T, versus other tourniquets which can pinch and cause a fair amount of discomfort. This is a small issue in the real world, but in training it may be the difference between whether someone trains with the product or doesn’t, and anything that encourages more, regular, practice is a good thing in my opinion. This comfort in practice is good also, as it does take some practice to become proficient in applying the SWAT Tourniquet one handed. It’s perfectly do-able, but it takes a few repetitions to get the hang of. Regular, repeated, practice will develop and keep the skillset sharp, and improve performance under stress (as is true and necessary with all skill).

It’s been somewhere in the neighborhood of ten months since I first put hands to a SWAT Tourniquet, and I’m no less enthused with the design than I ever was. It is the best of what good tools should be, simple and effective.
The only negative I’ve noted in the time I’ve spent with the SWAT Tourniquet, is that in training some individuals with larger thighs (and I mean quite large, the giant man ape types with thighs that’d put a lot of torso’s to shame), had problems getting effective tourniquation in some attempts. This is going to be a limiting factor for nearly any tourniquet on unusually sized individuals. In these cases, it simply reinforces the need to train with a variety of products and identify what works for each individual. In one individuals case, it was determined that a long-banded ratcheting tourniquet that could exert a maximum amount of pressure against his oversized and muscular thigh would present a better option for a tourniquet on him than the SWAT Tourniquet. I feel, however, that even among the Law Enforcement, Military, Fire/EMS, and prepared civilian communities that are often extremely fit and developed individuals, this will be a rare issue when dealing with the SWAT Tourniquet as the only time this problem was encountered was with nearly torso sized thighs.
While the SWAT Tourniquet may never replace full sized, more robust, mechanical tourniquets, it presents an ideal option for certain environments: Namely those in which space is limited, including plain clothes and civilian carry. Its compact nature, and cost efficiency, also make it ideal for adding redundancy to any medical or trauma kit. The SWAT Tourniquet is ideal for adding a high number of tourniquets to a small space, for responding to mass casualty incidents. In high profile incidents such as the Virginia Tech shooting, non-Medic personnel were vital in rendering aid and extricating wounded students. A handful of SWAT Tourniquets in an active shooter response kit would increase the ability of trained non-medics to provide quick and simple but potentially life-saving care on the go.

Multiple SWAT Tourniquets in a Medium Size Trauma Kit [Blackhawk Quad-Fold]

Comparison, Left to Right: Israeli Emergency Bandage, SWAT-T, CAT Tourniquet

In short, due to its effectiveness, simplicity and low cost, the SWAT Tourniquet is an extremely versatile option for almost any purpose or type of medical kit. At less than $10 (US) per unit, they are also extremely cost effective. I suggest everyone in need (and that’s everyone, in my opinion), check them out.
For more information, photos of the SWAT Tourniquet in use, demonstration videos or to order your own, go to: http://www.SWATTourniquet.com