Real User Results: Tactical Mechanical Tourniquet

In past articles, we’ve evaluated a couple of different CoTCCC-recommended tourniquets, including the SAM XT and the SOFTT-W. Today, David takes a look at the Tactical Mechanical Tourniquet (TMT) and gives us some thoughts on it.

What is the Tactical Mechanical Tourniquet

The Tactical Mechanical Tourniquet (TMT) is a windlass-style tourniquet put out by Combat Medical. It was added to the Committee of Tactical Combat Casualty Care (CoTCCC) in 2019.

Construction of the TMT

First, a little about the TMT:

The TMT is a good-feeling piece of equipment. Right off the bat, you’ll notice it is wider than many other tourniquets on the market, even some of those on the CoTCCC recommendation list. It boasts its 2″ wide band and claims to have better occlusion at lower pressures. The windlass is secured with a clip which provides an audible click and a tactile sensation when the windlass is secured. The materials are treated with IR and UV protection and do not feel cheap in any way. The windlass is sturdy and the buckles are made of a plastic that feels strong and durable.

Tactical Mechanical Tourniquet vs CAT
TMT (L) v CAT (R) strap width comparison

Trying It Out

I’ve had one of these sitting in my Stop The Bleed training box for a while and have shown students it during class as an available and recommended tourniquet, but haven’t spent much time actually using it.  In our training, we normally use the CAT tourniquet as or baseline/standard for training. I was recently teaching a larger class that used up all my CAT-style training tourniquets and used a TMT as a demonstrator. That’s where this article was born.

Applying the Tactical Mechanical Tourniquet

But here’s what I learned about the TMT in application:

The first time I self-applied the tourniquet to my arm (again, the standard we use to test our student’s practical application skills) it went flawlessly. I was able to secure the tourniquet well below our 30-second benchmark with no issue. As we had our students practice, I practiced along with them.

After a few reps, I switched arms and applied it to my dominant arm. I started the process and was making good time until I noticed something. Based on the direction that felt natural for me to spin the windlass, when it had tightened, somehow it made it so that I could not get the windlass into the securing clip as designed, at least not with one hand.

The clip can only be locked in from one direction.

Tactical Mechanical Tourniquet
The retention clip is only one direction

A few more reps later, I tried my dominant arm again, and you guessed it, the same results. I was unable to secure the windlass after applying the tourniquet.

I pointed this out to my partner, and we both took a minute to look at the awkward position of the windlass and clip. Now, this may not be an issue if you were to be applying it to your own leg, or applying the tourniquet on another person, but if you were in a situation where you needed to apply it one-handed to yourself, you could find yourself in a little predicament.

I plan on testing the TMT more in the future to verify if this was just a one-off experience, and if this is repeated, if it is possible to secure the windlass with two hands.

Another Consideration

As we worked with it a little more, we realized that the plastic backing on the TMT was quite a bit bigger than the CAT. It turns out, we couldn’t get the Tactical Mechanical Tourniquet to go as small as the CAT in terms of circumference. While this isn’t an issue on a battlefield full of adults, if your situation may include aiding children, this could be an issue.

The Bigger Lesson

There is a bigger lesson here. When I received these TMTs, rather than putting one into my EDC or a medical bag, I placed both into my training equipment. It goes to show how important it is to familiarize yourself with your equipment before carrying it in a real-life scenario. Not just tourniquets either. Be familiar with everything you are going to bet your life, or the lives of others, on.

We always recommend that students buy 2 tourniquets, one to carry and one to train with. (Note: Never use a tourniquet for practice that you plan to use for real-world applications.) We normally offer a variety of tourniquets in our class for our students to get their hands on and feel out different options to give them a launching point.

Current Recommendation

For me, my recommendation will continue to be the Combat Application Tourniquet (CAT) or the SOF Tactical Tourniquet–Wide (SOFTT-W). Both have proven themselves to be easy to use, including under stress. Over time, I may become more comfortable with the Tactical Medical Tourniquet, but I’m not there yet. Remember, this is my opinion. You may try the TMT and love it. But trying it should be part of the plan before making any decisions.

Just remember: When you buy a tourniquet, beware of fakes or knock-offs. These are typically inferior and may end up costing someone their life. Always buy from a reputable dealer, not just someone who knows how to set up a store space on Amazon. If you’re unsure of a dealer, contact us and we’ll tell you what we think.

If you’d like to learn how to use tourniquets, chest seals, and other items to control life-threatening bleeding, our Stop the Bleed classes are a great way to do it. In two short hours, you’ll learn how to save lives. Bring a friend with you. Contact us for more information or to schedule a class for your workplace, HOA, church, or other group.

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