|Best Overall||North American Rescue Combat Application Tourniquet (C-A-T), Gen 7||
Gen 7 of North American Rescue’s C-A-T tourniquet boasts lifesaving ease of use and plenty of top-level features, making this open-loop tourniquet one of the world’s best.
|Honorable Mention||Tactical Medical Solutions SOF Tourniquet Generation 4 (SOFTT-W)||
Tac Med Solutions’ SOFTT-W Gen 4 tourniquet has it all. This open-loop design features newly-added dual windlass clips and a tough construction, while providing speed, security, and easy of use.
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Whether a call comes over the radio of shots fired or you happen upon an accident while looking for spare parts at the local junkyard, you will be glad to have a tourniquet on hand and the training to use it. Of course, the challenge is finding the right one. A simple search on Amazon or Google may create confusion instead of lending a helping hand in your search for reliable gear. Add in a plethora of cheap Chinese knock-offs and low-quality offerings made in Bubba’s backyard, and sorting through the mess may make finding a top-tier tourniquet feel like fighting a lost battle.
Superior solutions do exist, and the Task & Purpose team is here to help. We prepared this piece just for you, using expert knowledge to prepare you for a worst-case scenario we all hope never comes.
One of the most common tourniquets on the U.S. market is the North American Rescue Combat Application Tourniquet (C-A-T), Gen 7. This unit was one of the first two tourniquets recommended by the CoTCCC and has inspired numerous imitators, most of which never come close to achieving the legendary status of the C-A-T. This particular tourniquet uses an open-loop design and can be staged for quick-and-easy, one-handed operation using the wide, hook-and-loop-equipped strap. To keep things simple, this tourniquet relies on a reinforced polymer windlass with ridges and grooves to provide a solid grip in both wet and dry conditions. The windlass is mounted to a stabilization plate for easier, more secure application. Once tightened down, the windlass is secured in place with the dual-wing clip, then secured with the hook-and-loop security strap which also doubles as a label for recording the unit’s time of application. The Gen 7 C-A-T skips screws, clips, and other fasteners in order to simplify use when fine motor skills have evaporated, and the red tip makes it easy to identify the end of the strap in high-stress situations. While prices may vary, the Gen 7 C-A-T can be found on the low end of CoTCCC-recommended tourniquets.
The Tactical Medical Solutions SOF Tourniquet Generation 4 (SOFTT-W) is one of the first two tourniquets ever to receive the CoTCCC recommendation, and despite its comparative lack of popularity, it boasts its fair share of advantages. Like many other tourniquets, the SOFTT-W features an open-loop design that can be staged for one-handed use. It uses a 5.5-inch windlass made with a single piece of anodized aircraft-grade aluminum. The aluminum is machined with a series of ridges and grooves for a positive grip and conical ends designed to minimize snagging during deployment and application. The SOFTT-W comes with the TRAC, a dual-wing clip, to easily secure the windlass during single-handed use, and the tri-ring next to it hooks into the deep grooves at either end of the windlass to provide extra security. The wide strap tightens down using the included strap buckle which includes a large loop designed to attach to a dedicated hook near the windlass. This design allows you to quickly and easily open the loop, slide one end under a leg or pinned arm, then close the loop for application. As with any good tourniquet, the tail of the strap includes a time label, making it possible to record the tourniquet’s time of application. The SOFTT-W is relatively affordable and is made in the U.S.A.
Why should you trust us
Prior to my career as a writer covering a variety of EDC gear, I served as a professional rescuer and lifeguard instructor for a number of years. In this role, I learned the value of high-quality life-saving skills and equipment and the life-threatening dangers of poor-quality alternatives. I will do my best to provide you, the reader, with access to top-tier rescue gear and professional advice, but when I hit the limits of my training, I will direct you to those who are better qualified than I am in order to set you up for safety and success.
How to use a tourniquet
Editor’s note: This guide is for informational purposes only and is no substitute for proper medical training.
Proper tourniquet application is one life-saving skill every prepared individual should have in his or her toolbelt, regardless of their occupation. In “safe” environments, severe bleeding can lead to death in a matter of minutes, but when your adrenaline and heart rate are already elevated, a severe wound could drop that interval to mere seconds. Cutting off the flow of blood from a massive open wound must be accomplished as quickly as possible whether the victim is you, a family member, a brother- or sister-in-arms, or a complete stranger.
To properly apply a tourniquet, make sure you prepare ahead of time. Learn how to apply it, especially single-handedly, because the life you save could be your own. Practice your skills, review them in your head whenever you can, and make sure to stage your tourniquet so that it is ready to deploy with ease and speed.
Once deployed, slip the loop over the injured limb, placing it at least three inches above the wound, but DO NOT place it over a joint. If you are unsure of the wound’s location, place the tourniquet “high and tight” (close to the victim’s shoulder or hip) instead. With the possible exception of clothing, make sure nothing is between the tourniquet and the injured limb. (Applying the tourniquet directly to bare skin will provide the best results possible.) Empty the victim’s pocket(s) as necessary, removing anything that could prevent a 360-degree application of pressure.
Once the tourniquet is in place and all obstructions have been removed, begin tightening the tourniquet using the appropriate application method for your tourniquet of choice. Tighten the tourniquet until the bleeding stops or the tourniquet cannot be tightened any further. Secure the windlass or any other critical moving part(s) into place.
Record the time of the tourniquet’s application, as this will provide later caregivers with the information they need to treat the patient properly. DO NOT loosen or remove the tourniquet unless instructed to by someone with higher medical credentials than yourself.
No matter the situation, always know and respect your own limits. Know your gear, understand how to use it, and put the victim’s well-being and quality of care first.
To see how to properly apply a tourniquet, check out these videos for the seventh generation C-A-T and fourth generation SOFTT-W tourniquets.
The most common types of tourniquets
All tourniquets rely on a strap of one kind or another to evenly apply pressure around the entire circumference of an injured limb. On a closed-loop tourniquet, this strap keeps both ends secured together near the cinching mechanism in order to decrease reliance on fine motor skills when your body is running on stress and adrenaline.
A favorite design of the CoTCCC, open-loop tourniquets consist of a single, unconnected strap with a cinching mechanism and buckle located at one end. The strap is run through the buckle, then secured in place once high pressure is created around the bleeding limb, usually via a hook-and-loop (i.e., Velcro) setup. Once properly tightened, the user will switch over to the cinching mechanism to achieve maximum pressure. Open-loop tourniquets are pre-staged to mimic a closed-loop system for one-handed use but can be opened up to more easily treat larger limbs with two hands.
Tourniquets are designed to serve as disposable, one-time-use tools for life-threatening situations. As such, the tourniquet you purchase today will not do its job if you train yourself or others with it. Training tourniquets feature reinforced stitching and parts designed to withstand the use and abuse seen in training sessions. Training tourniquets usually come in blue in order to help users distinguish them from the real deal.
What to look for when buying a tourniquet
Arguably the biggest danger in shopping for tourniquets is buying a poor-quality product or a cheap imitation of the real thing. As such, we strongly encourage buyers to find one from a reputable vendor or, if possible, directly from the manufacturer itself. Yes, online retailers, such as Amazon and Walmart, do have listings for the real McCoy, but due to the constant flux (and quality) of certain sellers on those platforms, many people have unwittingly purchased fakes. Sometimes, even sellers may be unaware of this issue due to their own lack of knowledge.
When shopping for a tourniquet, look for one that meets the standards of the Committee on Tactical Combat Casualty Care (CoTCCC), part of the U.S. military’s Joint Trauma System and America’s unofficial tourniquet standard setter. The CoTCCC maintains a list of tourniquets that are recommended for use in combat situations, setting a high bar for tourniquet performance. Are there other effective tourniquets on the market? Yes, but none of them inspire the confidence of those on the CoTCCC nice list, although some may imply CoTCCC approval.
Ease of application
Under elevated levels of stress, human beings may temporarily lose their fine motor skills, making normal tasks, like tying a shoe, significantly more complicated. When engines are smoldering or bullets are flying, the last thing you need is a tourniquet that requires two hands and an uncluttered mind to apply. A well-designed tourniquet should be designed for easy use and one-handed application.
Most common tourniquets rely on three common cinching mechanisms: windlass, ratchet, and elastic. Windlass designs tighten by using a T-handle to “screw down” the strap, while the ratchet mechanism tightens down in a manner similar to the straps on ski boots. Both of these cinching mechanisms rely on heavy-duty materials, such as aluminum or high-strength polymer to put on the pressure. On the other hand, elastic tourniquets are pretty self-explanatory, consisting of an elasticized band and a cleat designed to grab hold of and tighten the band.
In-hospital triage and care rely heavily on what care the patient has already received, and as such, medical professionals treating major hemorrhaging need to know when a tourniquet was first applied to their patient. As such, all good tourniquets will feature a tab or other location specifically designed to accept ink from that Sharpie in your EDC loadout. Apply the tourniquet, mark the time, then hand the patient off when help arrives.
The width of a tourniquet’s strap can directly affect whether or not a victim or casualty regains full use of their limb or not. While thin straps can be incredibly easy to store and transport, they also have the potential to more readily cause nerve and tissue damage when compared with their wide-band brothers.
Do you need a tourniquet?
Regardless of your profession or area of expertise, we highly recommend incorporating a tourniquet into your EDC loadout, assuming you are trained to use it. Obviously, professionals in high-risk or first responders fields, such as service members, law enforcement officers, EMTs, or heavy machinery operators, will benefit from keeping a tourniquet close at hand, and so too can the average student, housewife, banker, or tourist. Hypovolemic shock waits for no one to prepare, so properly staging a tourniquet in a purse, backpack, or diaper bag ahead of time could save someone’s life and limb when the car in front of you spins out into a series of shocking rolls. Tourniquets tend to be very lightweight, and with the proper setup, they can store away nicely in a plate carrier, an EDC bag, or even the console of your family minivan, ready to go at a moment”s notice.
Pricing ranges for tourniquets
Quality gear comes at a cost, and tourniquets are no exception. While you certainly can find tourniquets for under $15, you can bet your bottom dollar that they are likely cheap plastic knockoffs of proven designs that can break when you need them most. (Apparently, the Chinese have figured out some rather creative ways to try and take us down.) There are a handful of tourniquets that do not carry the CoTCCC’s seal of approval yet are still quite popular. Many of these can be found between $15 and $25, which is not a bad deal if you can find one that is known to consistently do its job without failure or a higher potential for nerve or other permanent damage compared to those on Uncle Sam’s nice list. To pick up a CoTCCC-recommended tourniquet, expect to drop somewhere between $25 and $30 on average, although some designs that recently made the list could cost you a good bit more.
How we chose our top picks
When reviewing new gear, we much prefer to go the hands-on route, but sometimes, a lack of resources may thwart our attempts to get our mitts on some cool gear. To make sure we don’t let you down, we take the time to listen to those who have firsthand experience, combing through reviews on Amazon, professional publications, enthusiast blogs, and more to bring you the best intel available. We sift through it all, keep the gold, and toss the rest.
In addition to our own in-person handling of the North American Rescue Combat Application Tourniquet (C-A-T), Gen 7, we found the expertise from the folks at the Committee on Tactical Combat Casualty Care (CoTCCC), ITS Tactical, JEMS, OffGrid, Personal Defense Network, Pew Pew Tactical, and PrepMedic to be extremely helpful in completing this review.
Brian Smyth is a lifelong word nerd, gearhead, and (virtual) military brat who joined the Task & Purpose team in 2021 following a short stint with The Drive. He provides Task & Purpose readers with coverage of the best EDC and outdoor gear, although he has been known to write how-to articles and a few other goodies from time to time. Contact the author here.