Junctional Tourniquet Training Experience

Kragh, John F; Geracci, James J.; Parsons, Donald L; Robinson, John B.; Biever, Kimberlie; Rein, Erling Bekkestad; Glassberg, Elon; Strandenes, Geir; Chen, Jacob; Benov, Avi; Marcozzi, David; Shackelford, Stacy; Cox, Kevin M.; Mann-Salinas, Elizabeth

doi:10.55460/chas-kzbq

Cited by 6 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One article conducted a review to record the experiences of several medical personnel in their junctional tourniquet training of users to provide a guide for future trainers. 24 Another article assessed and compared 2 junctional tourniquets (CRoC, JETT) during an advanced medical first responder course. 25 In this study, users ranked the JETT higher than the CRoC on all parameters, including effectiveness on the battlefield, ease of use, speed of application, and not slipping in use.…”

Section: Other Junctional Tourniquet Studiesmentioning

confidence: 99%

Junctional Hemorrhage Control for Tactical Combat Casualty Care

Kotwal

Butler

2017

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable, the majority are truncal, junctional, and extremity hemorrhage. Novel and effective approaches directed toward prehospital hemorrhage control have emerged in recent years, some of which can prove useful in the management of junctional hemorrhage whether in a military or civilian setting. An initial comprehensive review of junctional tourniquets was conducted by the Department of Defense Committee on Tactical Combat Casualty Care in 2013. The objective of this article is to provide an updated review of junctional hemorrhage control efforts and devices as they apply primarily to military prehospital trauma management and Tactical Combat Casualty Care and to prompt further consideration and application of these devices in nonmilitary prehospital, austere, and wilderness environments. Four junctional tourniquets are currently cleared by the Food and Drug Administration (FDA) for junctional hemorrhage control, and 1 junctional tourniquet is also FDA-cleared for pelvic stabilization. As junctional hemorrhage control efforts progress, scientists need to continue to conduct research and clinicians need to continue to monitor the performance of junctional tourniquets, especially in conjunction with morbidity and mortality outcomes, for both military and civilian trauma patients.

show abstract

Section: Other Junctional Tourniquet Studiesmentioning

confidence: 99%

Junctional Hemorrhage Control for Tactical Combat Casualty Care

Kotwal

Butler

2017

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

show abstract

“…Each of these tourniquets is recommended to be used for less than four hours for axilla and groin placements, while less than one hour is recommended for the abdomen [5,12]. However, studies have shown their utilization to be cumbersome and time consuming [15,16] and they have a high failure rate in training [17] and real combat scenarios [18]. Moreover, their effectiveness drops dramatically during patient transport [19].…”

Section: Introductionmentioning

confidence: 99%

Toward Smart, Automated Junctional Tourniquets—AI Models to Interpret Vessel Occlusion at Physiological Pressure Points

Avital,

Hernandez Torres,

Knowlton

et al. 2024

Bioengineering

View full text Add to dashboard Cite

Hemorrhage is the leading cause of preventable death in both civilian and military medicine. Junctional hemorrhages are especially difficult to manage since traditional tourniquet placement is often not possible. Ultrasound can be used to visualize and guide the caretaker to apply pressure at physiological pressure points to stop hemorrhage. However, this process is technically challenging, requiring the vessel to be properly positioned over rigid boney surfaces and applying sufficient pressure to maintain proper occlusion. As a first step toward automating this life-saving intervention, we demonstrate an artificial intelligence algorithm that classifies a vessel as patent or occluded, which can guide a user to apply the appropriate pressure required to stop flow. Neural network models were trained using images captured from a custom tissue-mimicking phantom and an ex vivo swine model of the inguinal region, as pressure was applied using an ultrasound probe with and without color Doppler overlays. Using these images, we developed an image classification algorithm suitable for the determination of patency or occlusion in an ultrasound image containing color Doppler overlay. Separate AI models for both test platforms were able to accurately detect occlusion status in test-image sets to more than 93% accuracy. In conclusion, this methodology can be utilized for guiding and monitoring proper vessel occlusion, which, when combined with automated actuation and other AI models, can allow for automated junctional tourniquet application.

show abstract

“…However, current junctional hemostatic devices can restrict thoracic movement and affect breathing when used in the axilla, which is also a concern in clinical use. 4 Therefore, this study is designed to experimentally verify the effect of SJT on respiration in a swine model of axillary hemorrhage with different respiratory states.…”

Section: Introductionmentioning

confidence: 99%