Bande de compression: Ne pas les vouer aux gémonies

Comparison of Two Tourniquets on a Mid-Thigh Model: The Israeli Silicone Stretch and Wrap Tourniquet vs. The Combat Application Tourniquet.

Glick CPTY et Al. Mil Med. 2018 Mar 1;183(suppl_1):157-161. doi: 10.1093/milmed/usx169.

 

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Le succès des garrots artériels tels que le SOFT-T et le CAT ne doit pas occulter l'intérêt des bandes de compression élastiques (Bande d'Esmach, SWAT-Tourniquet, IDF Silicone Tourniquet) préconisées en médecine rurale lors d'explosion de mines antipersonnelles (1). Ce travail met en avant leur efficacité.

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Introduction:

Experience from recent conflicts underlines the dramatic impact of effective tourniquet use on combat casualty mortality. Although the Combat Application Tourniquet (CAT) is replacing the silicone band tourniquets (IST; "Israeli Silicone Tourniquet") in the Israeli Defense Forces, no direct comparison was made between them. The purpose of this study is to compare the performance of the two tourniquets on a mid-thigh model.

Methods:

Participants were Israeli military recruits who previously had the military first aid course. Each participant applied both the CAT and the IST. Applications were assessed by the HapMed Leg Tourniquet Trainer, which measured the applied pressure and the time required to reach it.

Results:

IST application resulted in higher rates of effective occlusion pressure compared with the CAT (91% vs. 73.1%, p < 0.01), and a higher mean occlusion pressure (41 mmHg, p < 0.01) was recorded using the IST. Among effective attempts, application time did not differ significantly between the tourniquets.

Effect of Elapsed Time Since First Aid Course on Success Rate

	Experience More Than 1 mo (n = 15)	Experience Equal to or Less Than 1 mo (n = 63)	p-Value
Succeeded with CAT, n (%)	7 (46.7)	50 (79.4)	0.01
Succeeded with IST, n (%)	14 (93.3)	57 (90.5)	0.5

Conclusion:

The IST was superior to the CAT in producing effective occlusion pressure while not prolonging application time. These results may indicate that the IST remains a valid option for controlling mid-thigh bleeding.