- Tourniquet Recommendations
- Overall Best Tourniquet – North American Rescue Combat Application Tourniquet Generation 7 (C-A-T Gen 7)
- Alternate Best Tourniquet – SOF Tactical-Tourniquet Wide (SOFTT-W)
- Best Pneumatic Emergency Tourniquet – Delfi Medical Innovations Emergency & Medical Tourniquet
- Best Ratcheting Tourniquet – Ratcheting Medical Tourniquet (RMT)
- Upgrade Pick – SAM Extremity Tourniquet (SAM-XT)
- Tourniquets to Avoid
- What Is a Tourniquet?
- Types of Tourniquets
- Features to Look For
- Tourniquet Holders
- Tourniquet Holder Recommendations
As much as I love nature, I know she is a potentially cruel mistress.
There are many hazards when exploring the woods and deserts of this world which can injure you and leave you bleeding to death surrounded by animals and stars.
Of course, the unthinkable could happen at home, too. Tornadoes, in particular, seem to have it out for houses.
This is why everyone should own and know how to use tourniquets.
Sometimes abbreviated TQ, tourniquets are an indispensable tool to stop bleeding everyone hopes they’ll never have to use.
Up until May 6th, 2019, the CoTCCC only recommended the first three tourniquets. The rest are recent recommendations.
|C-A-T Gen 7||Windlass||Adults||4.8||$$
|RMT||Ratcheting||Adults & Children||4.8||$$$
Overall Best Tourniquet – North American Rescue Combat Application Tourniquet Generation 7 (C-A-T Gen 7)
The CAT-7 tourniquet is perhaps the most commonly recommended TQ in the US.
It’s what I carry, and it’s what most of my friends carry.
It has a polymer windlass that pulls a strap within the strap for fast tightening. A Velcro strap holds it in position.
I’ve found the CAT-7 very easy to put on quickly, especially since you can stage it in several different ways. Just make sure to position the Velcro timing/retention strap to one side before you need to use the tourniquet!
The other big tourniquet is the SOFTT-W. It’s tougher than the CAT-7 and has an aluminum windlass that’s anodized to cut down on glare.
It’s an extra-wide tourniquet, so you occlude as much blood flow as possible. A retention clip holds the windlass secure once wound.
There’s also a quick-compression buckle so the strap won’t get caught when you apply the SOFTT-W with one hand.
It’s also available in a variety of colors.
The SOFTT is good, too, but I prefer the wide version.
Best Pneumatic Emergency Tourniquet – Delfi Medical Innovations Emergency & Medical Tourniquet
The Delfi E.M.T. is a pneumatic tourniquet.
You loop it around the wounded limb then squeeze the air bulb to inflate a central tube, blocking blood flow.
This may be more comfortable than the strap-based CAT-7 and SOFTT-W tourniquets with less potential nerve damage.
However, it’s harder to find a Defli E.M.T. for sale and they take up more room in your gear.
The RMT is a series of similar tourniquets, all using a ratcheting system to tighten the TQ.
A ratchet isn’t as fast as a windlass and is more likely to be jammed by clothing. However, they have a big advantage over windlass TQs:
They can close to a smaller diameter.
This makes the RMT, especially the pediatric version (aka CRMT), a great choice if you have children with you.
The RMT is also smaller than the CAT-7, so you can carry it more easily.
The SAM-XT is a relatively new tourniquet.
It’s not exactly unproven, but it doesn’t have the reputation of a CAT-7 or SOFTT-W yet. It does have some interesting upgrades.
The most obvious new feature is a series of holes in the strap. The SAM-XT uses both Velcro and locking prongs to hold the strap in place before windlassing. This eliminates slack and makes the tourniquet more effective.
The SAM-XT might be a better tourniquet than my beloved CAT-7 for extreme weather because of this.
Tourniquets to Avoid
Any Knock-Off Tourniquet
You can go cheap on some items. A knock-off backpack may not last as long as the real deal but won’t endanger your life if some stitching fails.
That doesn’t apply to tourniquets.
TQs need to be extremely strong and dependable. You can’t guarantee that if you buy a Chinese copy of a CAT-7.
People sometimes think they can get away with knock-offs. Until they use them.
They won’t even hold up to practice, let alone field use, so don’t risk it.
The RATS tourniquet became very popular for a while.
It’s supposed to be a low-profile tourniquet that can be applied faster than any other tourniquet.
However, their marketing is just a lot of hot air. They’ve even carefully worded some advertisements to deceive people into thinking they’re CoTCCC approved, which isn’t the case.
It’s especially telling that RATS did not make it onto the CoTCCC’s recent list of approved tourniquets.
The RATS tourniquet is slower and less effective than other tourniquets. Don’t fall for the hype!
There is an exception.
The RATS tourniquet is capable of working on a smaller diameter limb than most other tourniquets.
So, if you have children, don’t discount the RATS tourniquet!
What Is a Tourniquet?
A tourniquet is a loop of material used to stop bleeding.
Modern tourniquets are made from advanced materials such as polymer, aluminum, and nylon. Hook and loop fields can be used to hold a strap in place and buckles are often used to give you an advantage in applying pressure.
Also, there’s a more advanced method to apply mechanical pressure, which will be explained later.
How Does One Work?
A tourniquet works to stop death by bleeding by blocking all blood flow from the heart to the wound. This is effective at saving lives.
Tourniquets do this by applying pressure all the way around a limb. This cuts off any arteries, which are the main source of blood when hemorrhaging. Veins and capillaries get blocked, too.
This type of blockage is called “occlusion” and prevents death via exsanguination.
Note that tourniquets can only be used on your arms and legs. They do nothing for cuts on your torso and should never be used on somebody’s neck!
To learn more about using a tourniquet, check out our article about stopping bleeding in the wild.
Types of Tourniquets
There are two basic types of emergency tourniquets:
- Strap tourniquets
- Elastic tourniquets
Both of those have to tightened enough to cut off all blood flow. You can theoretically use any elastic or strap as an elastic tourniquet, but those are fiddly to use, are less comfortable, and can be prone to failure.
Strap tourniquets are easier to put on with one hand and are then tightened through some sort of method that doesn’t require you to exert much physical force. This makes strap tourniquets more effective and safer than elastic tourniquets.
Features to Look For
No matter which tourniquet you use, make sure it’s approved by the Committee on Tactical Combat Casualty Care (most of the time).
TCCC is a US military organization that uses battlefield experiences and the latest in healthcare research to figure out which lifesaving methods are the best.
I prefer following the CoTCCC recommendations because even if you’re not in a war, wilderness survival is more similar to battlefield survival than it is to urban survival.
Both soldiers and survivalists are put in situations where the closest ambulance is a helicopter from a hundred miles away and you may have to crawl through brambles and muck to get to a car.
So, for our purposes, let’s follow the military recommendations.
It’s almost impossible to tighten a tourniquet by pulling the strap. You need it tight enough to cut off all blood flow, which is difficult if you can use two hands and impossible if you can use only one hand.
This is why all good tourniquets have a method to give you a mechanical advantage.
Most common is a windlass. You strap the tourniquet in place and twist the windlass to tighten the TQ. It’s fast and easy to do with one hand.
Some tourniquets use pneumatics to tighten the strap as well. These can be more awkward to apply with one hand, are slower to use, and take up more space on your kit but are more comfortable when tightened and are less likely to cause damage.
Elastic tourniquets are wrapped multiple times then tucked under themselves. This is easy to apply two-handed but hard to do one-handed. However, they can also be used as a pressure bandage.
Ratcheting tourniquets use, well, a ratchet to tighten. This is easy to do one-handed but a piece of clothing can jam the mechanism.
Once you’ve spun the windlass around enough for you to be unable to stick three fingertips under the tourniquet, you need to be able to hold the windlass in place.
A retention clip or Velcro strap helps you do this.
Tourniquets are used when seconds matter, so it needs to be designed for you to be able to apply it to a limb with one hand in as few moments as possible.
The fewer buckles you need to route the strap through the better.
Your best chances at survival come when you use a tourniquet you can “stage,” which is when you pre-loop it so it’s halfway to being usable even when stored.
All CoTCCC-recommended tourniquets can be applied and tightened in under 30 seconds, except maybe the Delfi pneumatic tourniquet (which is still that fast if you’re well practiced).
The exception to following CoTCCC recommendations is if you need to occlude the blood flow in a particularly small limb, such as those of a small child or dog.
If you have children or a beloved canine, it may be a good idea to carry an extra TQ which can form a smaller diameter loop, such as the CRMT or RATS.
A tourniquet is only useful if you have it on you.
In fact, you should either place the tourniquet where it’s easily used by either hand or you should carry two TQs, one for each hand.
What is a Tourniquet Holder?
A good tourniquet holder does two things:
A TQ is useless if it falls off your belt. So, a tourniquet holder will keep the TQ in place and also allow you a fast draw then necessary.
As for damage, the number one threat to your tourniquet’s longevity is ultraviolet light. Too much UV light will cause the TQ’s material to weaken, causing it to break instead of tighten to the appropriate amount of pressure.
Thorns and stray blades can damage your tourniquet as well, but that’s a much smaller consideration than blocking UV light.
Features to Look For in a Tourniquet Holder
The main thing to look for in a TQ holder is to make sure you can get to the TQ when you need to.
A zippered pouch is a horrible place to put your TQ because you don’t want to have to fiddle with a bloody zipper when you’re bleeding to death.
It’s fine to keep backup tourniquets zippered away, but you should have at least one TQ stored in a place that’s easy to draw from.
This can look like elastic bands, a rigid holster, or even a pouch with a Velcro flap. So long as it’s easy to pull the TQ from.
You’ll also need a good clip, belt loop, or MOLLE attachment. You don’t want a branch pulling off your TQ while you’re preoccupied.
Tourniquet Holder Recommendations
|Blue Force Gear Tourniquet Now!||Elastic||MOLLE||4.3||$$
|NAR CAT-7 Case||Rigid||Belt Clip and MOLLE||4.3||$$$$
|NcSTAR Tourniquet & Tactical Shear Pouch||Pouch||Belt Loop and MOLLE||4.1||$
The Blue Force Gear Tourniquet Now! is a polymer base and two elastic straps.
The two straps hold your tourniquet in place. They don’t really protect against UV light but they do make for an extremely fast draw in both directions.
The Tourniquet Now! attaches to MOLLE webbing, though you may be able to attach it to a bug out bag, belt, or strap with some fancy knotwork.
It’ll fit most tourniquets on the market, though I believe it may not work with the Delfi E.M.T.
You should consider your tourniquet a limited-lifespan item if you keep it in this holder long-term because of potential UV damage.
But hey, that gives you an excuse to practice with your old tourniquet!
North American Rescue’s rigid tourniquet case is a TQ holster that fits no tourniquet but the CAT-7.
It’s made from injection molded nylon and can withstand impacts and weather. It also keeps most of the TQ away from UV light.
You can choose between black and coyote tan colors.
The case can be worn either vertical or horizontal. It’s designed to be worn on a belt up to 2.25″ wide but can be worn on webbing instead.
There’s also a shirt shield to prevent the windlass clip from causing wear.
It even has a tiny medical cross patch, in case someone can’t tell it’s a medical tourniquet.
I’m normally not a huge fan of NcSTAR but their tourniquet pouch is pretty great.
It attaches to either MOLLE or a belt loop and can be worn vertical or horizontal.
There’s also a hook and loop field on the front of the flap if you want to add a patch, but the embroidered red “TQ” works well enough to tell rescuers what’s inside.
A flap covers the tourniquet and blocks all UV light.
The flap attaches to the pouch via Velcro and is fast to open, especially with the small tab.
It should be able to fit most tourniquets because this pouch’s sides are elastic.
The gravy on top is a hook and loop strap to hold trauma shears in place.
I firmly believe that everyone should carry a tourniquet and know how to use it.
It’s even better to carry several TQs. One set up for immediate access and the others stored safely away for particularly heinous emergencies.
You can’t go wrong with the CAT-7 tourniquet in most cases. It’s the most used, highest praised tourniquet available today.