December 25, 2017 0 Comments

The Efficacy of Commercial Pre-Hospital Tourniquets vs. Improvised Tourniquets and Surfers

The efficacy of commercial pre-hospital tourniquets is well established. To date the majority of the data and studies related to tourniquet use are from battlefield reports and studies, with the exception of a few civilian reports and studies. There has not been a specific study as it relates to maritime professional or water sport participants such as surfers. Many surfers erroneously believe that their leash also known as a leg rope can be improvised into a tourniquet if needed. While they are not wrong, they are not right either.

Improvised tourniquets are generally not recommended for a variety of reasons:

 

1. Improvised tourniquets are not medical devices. This means they are not designed as a tourniquet, they are not made with the quality management, regulations, or scientific evidence required of medical devices. Hence, why studies have shown that improvised tourniquets have a 75% failure rate (Kragh et al, 2008).
2. Unreliable compression: Improvised tourniquets as they relate to surfers are generally traditional polyurethane leash (leg rope) cords. These cords are made from a material known as polyurethane, which is designed to stretch repeatedly and maintain its shape. The typical diameter of a surf leash is 7mm, but can be as thin as 5mm, or as thick as 9mm. If wrapped around a limb a person may believe that the cord is holding its form, but due to the material properties the polyurethane continues to stretch even though you can’t see it happening. You may think you have stopped the bleed, only to find it bleeding again shortly thereafter.
3. Complications: Improvised tourniquets put injured people at greater risk of developing complications, which is why the Australian Resuscitation Council does not recommend their use. For example, we’ll use the leash cord again; it may appear that bleeding has slowed but in all likelihood improvised tourniquets have been found to occlude venous blood flow relatively easily, however, without the arterial blood flow occlusion compartment syndrome is likely to develop. Compartment syndrome occurs when the veins are occluded trapping blood in a limb preventing it from returning to the body to be re-oxygenated by the heart and pumped back out through arteries. Treatment of compartment syndrome may require what is known as a fasciotomy. In addition, the narrow nature of a leash cord used as a tourniquet would also require the need for higher amounts of pressure to reach occlusion pressure resulting in further tissue damage (See Figure 1).

 

OMNA TQ / TQ Leg Ropes vs. Improvised Leg Rope Cord
62.23 cm	Average Male Leg Circumference				24.5 inch
36.83 cm	Average Male Arm Circumference				14.5 inch
Limb Occlusion Pressure (LOP) = (Limb Circumference / TQ Width) * 16.67 + 67
Limb	7mm Leg Rope		OMNA TQs		Difference
Leg	1526	mmHg	271	mmHg	-1254
Arm	930	mmHg	188	mmHg	-742
Results:
OMNA TQs: occlude arterial blood flow in safe range of 300 - 500 mmHg
Leg Rope Cord: does not occlude in safe range; pressure required unlikley to be reached

Figure 1: When comparing the efficacy of OMNA Tourniquets vs. the improvisation of the traditional leash cord you can see the required pressure to reach occlusion is far less for OMNA TQs. The safe range for limb arterial occlusion is 300 – 500 mmHg. The predicted limb occlusion pressure of a leash / leg rope cord is estimated to be 2 to 3 times more than the safe amount of compression. In contrast, OMNAs Tourniquet is estimated to reach occlusion pressure less than the safe range or in the safe range depending on the size of the patient.

The OMNA Tourniquet Solution: 

Since improvised tourniquets are less than ideal we have developed specific marine tourniquets for maritime professionals and water sports. Surfers who surf with an OMNA Tourniquet Leash have a scientifically tested and proven tourniquet integrated directly into their leash / leg rope. This provides surfers with a legitimate means to stop bleeding to save a life if needed in the water, and is also readily available in their car to and from the beach for any other type of accidents where a tourniquet may be indicated to save a life. In addition you can easily detach the Tourniquet from the leash and wear or carry the tourniquet with you camping, hiking, or the like. Considering, that the average of a 6’ leg rope from Dakine, FCS, O&E, or Creatures is $28-$32 dollars, and OMNAs 6’ Tourniquet Leash retails for $34.99 surfers only pay $3 to $7 more for a device that retains your board and is a legitimate class 1 medical device. That’s a hell of a deal, and you won’t find any traditional leash manufacturer making their traditional leashes with anything near the quality management standards OMNA uses.

4. Testimonials:
   1. “The leash cord didn’t stop the bleeding.” (Shark attack survivor April 2017, San Onofre State Beach, CA, USA). – Leeanne Ericson
   2. "If Ben or someone around him had been surfing with an OMNA Tourniquet Leg Rope he’d be alive today.” (Brother of Ben Gerring who died from blood loss June 2016, Perth, WA, Australia). - Rick Gerring

 

Essentially, Improvised Tourniquets are more likely to make a bad situation worse, than to stop bleeding. Therefore, we recommend you do the following marine activities with one of our tourniquets.

           

• Surfing
• Paddle Boarding
• Body Boarding
• Kite Surfing
• Wake Boarding
• Scuba Diving
• Free Diving
• Snorkeling
• Spearfishing
• Swimming
• Boating
• Sailing
• Fishing
• Snorkeling
• Body Surfing
• Kayaking

           

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