Garrot: A partir de quand est on fiable ?

Single versus Double Routing of the Band in the Combat Application Tourniquet.

J Spec Oper Med. 2013 Spring;13(1):34-41.

Le sauvetage au combat met en avant l'importance d'arrêter toute hémorragie le plus tôt possible. Le garrot tient là une place essentielle. Mais à partir de quand l'apprentissage de cette technique peut il être considéré comme optimal. Une réponse est apporté par ce travail: La maîtrise de ce geste semble être obtenue à partir de 30  poses.

Background: Common first aid tourniquets, like the Combat Application Tourniquet (CAT) of a windlass and band design, can have the band routed through the buckle in three different ways, and recent evidence indicates users may be confused with complex doctrine.

Objective: The purpose of the present study is to measure the differential performance of the three possible routings in order to better understand good tourniquet practice.

Methods: A training manikin was used by two investigators to measure tourniquet effectiveness, time to stop bleeding, and blood loss.

Results: The effectiveness rate was 99.6% (239/240) overall. Results were similar for both single-slit routings (inside vs. outside, p > 0.05). Effectiveness rates (yes-no results for hemorrhage control expressed as a proportion of iterations) were not statistically different between single and double routing. However, the time to stop bleeding and blood loss were statistically different (p < 0.05).

Conclusions: CAT band routing, through the buckle either singly or doubly, affects two key performance criteria: time to stop bleeding and volume of blood lost. Single routing proved to be faster, thereby saving more blood. Learning curves required to optimize user performance varied over 30-fold depending on which variable was selected (e.g., effectiveness vs. blood loss).