Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: While windlass-rod style tourniquets stop bleeding in limbs when used by skilled responders, they are less successful in the hands of the untrained or not recently trained public. To improve usability, an academic-industry partnership developed the Layperson Audiovisual Assist Tourniquet (LAVA TQ). The LAVA TQ is novel in design and technology and addresses known challenges in public tourniquet application. A previously published multisite, randomized controlled trial of 147 participants showed that the LAVA TQ is much easier for the lay public to use compared to the Combat Application Tourniquet (CAT). This study evaluates the LAVA TQ’s ability to occlude blood flow in humans compared to the CAT.

Methods: This study was a prospective, blinded, randomized controlled trial to demonstrate the non-inferiority of the LAVA TQ to occlude blood flow when applied by expert users compared to the CAT. The study team enrolled participants in Bethesda, Maryland, in 2022. The primary outcome was the proportion of blood flow occlusion by each tourniquet. The secondary outcome was surface application pressure for each device.

Results: The LAVA TQ and CAT occluded blood flow in all limbs (21 LAVA TQ, 100%; 21 CAT, 100%). The LAVA TQ was applied at a mean pressure of 366 millimeters of mercury (mm Hg) (SD 20 mm Hg), and the CAT at a mean pressure of 386 mm Hg (SD 63 mm Hg) (P = 0.14).

Conclusion: The novel LAVA TQ is non-inferior to the traditional windlass-rod CAT in occluding blood flow in human legs. The application pressure of LAVA TQ is similar to that used in the CAT. The findings of this study, coupled with LAVA TQ’s demonstrated superior usability, make the LAVA TQ an acceptable alternative limb tourniquet.