The XForce Tourniquet: A Comparative Analysis with the CAT Tourniquet to Advance Efficacy and Establish Foundations for Smart Hemorrhage Control

Abstract

Background: Tourniquets have demonstrated life-saving efficacy within military settings as essential tools in hemorrhage control. Despite their proven effectiveness, traditional windlass-based tourniquets such as the Combat Application Tourniquet (CAT) present challenges in rapid application and ease of use, particularly within civilian emergency contexts. The XForce Tourniquet (XForce TQ) has been developed to address these limitations with a novel ratcheting mechanism and self-securing strap. These design features aim to improve usability and application speed while also demonstrating the XForce tourniquets ability to serve as the foundation for broader telemedicine tourniquet initiatives. Methods: This study conducted a comparative evaluation of the XForce TQ and CAT TQ among healthcare professionals (n = 99) using a simulated limb model (TQ Aid). Participants applied both tourniquets in three timed trials each with application times recorded at key steps. The study assessed differences in mean total application time, user performance across age and sex groups, and overall device efficiency. Statistical analyses included paired t-tests and ANOVA to determine significance. Results: The XForce TQ significantly reduced mean total application time (8.67 +/- 2.12 s) compared to the CAT TQ (16.53 +/- 4.43 s, p < 0.001), representing a 47% reduction in total application time. Significant differences were also observed between sexes, with females taking longer to apply both tourniquets (p < 0.05). No significant differences in application time were found between age groups (p = 0.852). The ratcheting mechanism of the XForce TQ demonstrated improved user efficiency and reduced application variability. Conclusion: The XForce TQ offers significantly faster application times than the CAT TQ, suggesting that its novel design enhances usability in emergency scenarios. These findings support the development of next-generation intelligent tourniquets integrating smart features such as automated emergency alerts and telemedicine capabilities. Further research is needed to validate its performance in real-world trauma settings.

Competing Interest Statement

NY serves as an advisor, consultant, or board member for Turnkey Learning, LLC; Turnkey Learning (P) Ltd; Research Spark Hub; and Magnetic 3D. Additionally, Dr. Yanamala holds patents with Rutgers (US202163152686P; WO2022182603A1; US202163211829P; WO2022266288A1; US202163212228P; and WO2022266291A1) and with West Virginia University (invention numbers 2021-20 and 2021-047). All other authors (AA, EP and AB) have no relevant disclosures related to the contents of this paper.

Funding Statement

This research was supported by grant funding from the New Jersey Commission on Science, Innovation, and Technology (CSIT) as part of its initiative to support New Jersey startups i.e., in this case Novara Solutions LLC..

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics approval and consent to participate This study was determined to be non-human research and, therefore, did not require institutional review board (IRB) approval. The study was conducted in accordance with ethical guidelines that prioritized confidentiality and integrity of the data.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

Comments (0)

No login
gif