1. 2010 Tourniquet Working Group: Requirements & Test Parameters CDR Tyson Brunstetter, MSC, USN Chief, Joint Medical Test & Evaluation Division Hemostatic Dressings & Tourniquets IPR 25 April 2012 1CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified

2. Introduction Tourniquet (TQ) Working Group Meeting – 23 March 2010, Hosted by DMMPO – Goal: Reach consensus on TQ requirements & testing protocols Today’s brief: To summarize recommended requirements and T&E parameters for extremity TQs 2CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified

3. 3 2010 TQ WG: Consensus RQMTs

4. 4CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified -- REQUIRED ATTRIBUTES --

5. 2010 TQ WG: Consensus RQMTs 5CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified -- REQUIRED ATTRIBUTES --

6. 2010 TQ WG: Consensus RQMTs 6CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified -- DESIRED, BUT NOT REQUIRED ATTRIBUTES --

7. 7CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified -- DESIRED, BUT NOT REQUIRED ATTRIBUTES -- 2010 TQ WG: Consensus RQMTs

8. 8CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified -- DESIRED, BUT NOT REQUIRED ATTRIBUTES -- 2010 TQ WG: Consensus RQMTs

9. 9CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified 2010 TQ WG: Consensus Testing Efficacy-ScreeningOperational

10. 10CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified General Protocol – For Efficacy-Screening & OT Collect baseline subject data (height, weight, limb circumference, baseline BP and HR), 20-min supine acclimation Subject Clothing: Surgical scrubs and current Army ACUs Tourniquets – Two conditions: (1) Dry and (2) soaked in blood analog solution – Tightening halted at cessation of Doppler signal; TQ pressure noted – Removed immediately if intolerable pain to the subject – Released slowly to confirm re-establishment of Doppler signal Administrators/Subjects: Trained in TQ application prior to testing

11. 2010 TQ WG: Efficacy Testing/Screening 11CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified Experiment 1 Locate & mark lower extremity popliteal artery Locate & mark location of TQ application @ mid-thigh Apply TQ, measure arterial blood flow at popliteal artery site via Doppler ultrasonography Effectiveness defined as cessation of Doppler signal Experiment 2 Effective devices move on to Experiment 2

12. 12CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified Experiment 2 Locate & mark radial artery Locate & mark location of TQ application @ mid- humerus Apply TQ, measure arterial blood flow at radial artery site via Doppler ultrasonography Effectiveness defined as cessation of Doppler signal 2010 TQ WG: Efficacy Testing/Screening

13. 2010 TQ WG: Operational Testing 13CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified Test Procedure: Upper & Lower Extremities Locate & mark extremity artery Prior to application of tourniquet, subject performs 20, eight-count body builders (jumping jack, push-up, squat jump, stand) to simulate operational duress Immediately apply TQ to own limb Measure arterial blood flow via Doppler Effectiveness defined as cessation of Doppler signal Survey assesses training, packaging, and ease of use

14. 2010 TQ WG: Operational Testing 14CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified Test Procedure: Repeated w/ following variables Blood solution-soaked TQ w/dominant hand Dry TQ w/dominant hand Blood solution-soaked TQ w/non-dominant hand Dry TQ w/non-dominant hand Blood solution-soaked TQ using Night Vision Goggles Dry TQ using Night Vision Goggles

15. Questions? CDR Tyson Brunstetter Tyson.Brunstetter@amedd.army.mil (301) 619-9028 15CDR Tyson Brunstetter / 301-619-9028, DSN 343, tyson.brunstetter@amedd.army.mil Unclassified