Junctional Tourniquets in the Prehospital Setting: Controlling Hemorrhage Where It Counts

 ​

Uncontrolled hemorrhage remains a leading cause of preventable death in trauma cases, particularly when injuries occur in areas not amenable to traditional limb tourniquets. Junctional tourniquets have emerged as vital tools in the prehospital setting to address bleeding in regions such as the groin (inguinal), armpit (axilla), and pelvis. These devices are specifically engineered to control hemorrhage where standard tourniquets are ineffective.​NCBI

Understanding Junctional Tourniquets

Junctional tourniquets are designed to apply targeted pressure to compress blood vessels in junctional areas, thereby controlling bleeding. Their application is crucial in scenarios involving high-impact injuries, such as those caused by motor vehicle accidents or explosive devices, where rapid hemorrhage control can significantly improve survival rates.​ NCBI

Notable Junctional Tourniquet Devices

1. SAM Junctional Tourniquet (SJT): Developed by SAM Medical, the SJT is designed for quick application and is capable of controlling hemorrhage in under 25 seconds. It features the patented AUTOSTOP buckle to ensure optimal compressive force and includes inflatable bladders for targeted pressure. ​mrdc.health.mil, NCBI, SAM Medical Store, SAM Junctional Tourniquet Training, SAM Junctional Tourniquet (SJT), SAM Junctional Tourniquet Training, SAM SJT Application, 

2. Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S): Manufactured by Compression Works, the AAJT-S is a multi-functional device applicable for controlling hemorrhage in the abdominal, axilla, and inguinal regions. It can also aid in pelvic fracture stabilization and serve as a Zone 3 REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) device. Compression Works

3. Junctional Emergency Treatment Tool (JETT): Designed for rapid application, the JETT addresses high-inguinal and axillary injuries. It employs mechanical advantage to achieve necessary compression and is suited for situations where time and ease of use are critical.​ NCBI, North American Rescue, Junctional Emergency Treatment Tool (JETT) Application.

Training and Application

Proper training is essential for the effective use of junctional tourniquets. SAM Medical offers comprehensive training materials for the SJT, including instructional guides and videos demonstrating applications for various injury sites. mrdc.health.mil, NCBI, SAM Medical Store, SAM Junctional Tourniquet Training, SAM Junctional Tourniquet (SJT), SAM Junctional Tourniquet Training, SAM SJT Application, 

For visual demonstrations, SAM Medical provides a series of training videos detailing the application of the SAM Junctional Tourniquet:​ Junctional Tourniquet Application ⎮SJT⎮ - YouTube

Conclusion

Incorporating junctional tourniquets into prehospital emergency protocols enhances the capability to manage complex hemorrhagic injuries effectively. Devices like the SAM Junctional Tourniquet, AAJT-S, and JETT provide targeted solutions for bleeding control in areas where traditional methods are insufficient. Ongoing training and familiarity with these devices are imperative for first responders and medical personnel to optimize patient outcomes in trauma scenarios.​ Compression Works, SAM Medical Store, North American Rescue.