Initial tourniquet pressure does not affect tourniquet XXXX .

@entity432 @entity468 @entity71603
BACKGROUND: Effective nonelastic @entity71603 -based tourniquets are typically pulled tight and friction or hook-and-loop secured before engaging a mechanical advantage system to reach @entity432 . This study examined the effects of skin surface initial secured pressure (Friction Pressure) on the skin surface pressure applied at @entity432 (Occlusion Pressure) and on the use of the mechanical advantage system. METHODS: Combat Application Tourniquets   ( @entity468 ; combattourniquet.com) and Tactical Ratcheting Medical Tourniquets (RMTs; www .ratchetingbuckles.com) were applied to 12 recipient thighs with starting Friction Pressures of 25 (RMT only), 50, 75, 100, 125, 150, 175 (CAT only), and 200mmHg (CAT only). The CAT @entity71603 was single threaded. Pressure was measured with an air-filled, size #1, neonatal blood pressure cuff under the Base (CAT), Ladder (RMT), and @entity71603 (CAT and RMT) of each 3.8cm-wide tourniquet. RESULTS: Base or Ladder pressure and @entity71603 pressure were related but increasingly different at increasing pressures, with @entity71603 pressures being lower (Friction Pressure, r > 0.91; Occlusion Pressure, r > 0.60). Friction Pressure did not affect Occlusion Pressure for either design. Across the 12 thighs, the correlation coefficient for @entity71603 Friction Pressure versus CAT windlass turns was r = -0.91    0.04, and versus RMT ladder distance traveled was r = -0.94    0.06. Friction Pressures of 150mmHg or greater were required to achieve @entity432 with two or fewer windlass turns. CAT and RMT @entity71603 Occlusion Pressures were similar on each recipient (median, minimum - maximum; CAT: 318mmHg, 260 - 536mmHg; RMT: 328mmHg, 160 - 472mmHg). CONCLUSIONS: Achieving high initial @entity71603 tension is desirable to minimize windlass turns or ratcheting buckle travel distance required to reach @entity432 , but does not affect tourniquet surface-applied pressure needed for @entity432 . For same-width, nonelastic @entity71603 -based tourniquets, differences in the mechanical advantage system may be unimportant to final tourniquet-applied pressure needed for @entity432 .
