"Optimizing Combat Casualty Care"
The intelligent tourniquet integrates the tourniquet concept with computer technology to build the next-generation tourniquet system.

The intelligent tourniquet integrates the tourniquet concept with computer technology to build the next-generation tourniquet system. Photo by Steven Galvan

Tourniquets of the Future: Intelligent

By Steven Galvan, Public Affairs Officer
U.S. Army Institute of Surgical Research
03 MAY 2012

Improving existing products is not a new concept, especially at the U.S. Army Institute of Surgical Research (ISR). Research on extremity injuries at the ISR in 2004 resulted in the issuance of improved tourniquet devices to all U.S. troops deployed to combat by the Department of Defense in 2005, resulting in a reduction in battlefield deaths from limb exsanguinations. Scientists at the ISR are now looking into improving this effective tool that is saving lives in the battlefield by integrating the tourniquet concept with computer technology to build the next-generation tourniquet system known as the Intelligent Tourniquet (iTK).

According to Jose Salinas, Ph.D., Research Task Area Program Manager of Combat Critical Care Engineering at the ISR, the iTK was recently developed through a partnership between the ISR and Athena GTX. “The new intelligent tourniquet system is retrofitted on top of existing tourniquet devices that are in use now,” said Salinas. “It is basically a compact air bladder, sensor suite, and wireless computer control system that fits onto existing tourniquets to provide automated control of tourniquet activation based on patient sensor data or at the direction of a nearby medic through a wireless connection to the iTK.”

Research data has shown that tourniquets are saving lives in the battlefield and that warriors who were wounded and incapacitated or in a location where a field medic could not reach them died.

“There is a need for this [iTK],” said Dr. John F. Kragh, an orthopedic surgeon and the only full-time tourniquet researcher at the ISR. “Soldiers need this and it would save more lives.”

“This is still very much in the prototype stages,” Salinas said. “We’re working on creating a program around this; so hopefully in a few years we’ll have a system that we can test on patients. However, we feel this will be the future for improving outcomes due to extremity injuries on the battlefield. Use of computer technology to drive advances in medical device development will be key to making this system a success.”

The iTK is fitted with a computer the size of a pack of playing cards and can be activated or deactivated at the point of injury by the wounded warrior or remotely from another location. The computer can also monitor the patient’s vital signs and interventions. “So it can actually use the physiology of the patient to help better manage the tourniquet,” said Salinas. “For example, if the unit notices that the blood pressure is starting to stabilize, then the computer system would tell the control units to loosen the tourniquet and profuse the limb if it needs to be profused.”

The vision is to eventually fit battle uniforms with the iTK along with sensors that would detect a blast going off around the warrior and automatically deploy. If it were to activate and not be needed, then the warrior would simply push a button on the computer to deactivate it. The hope is to eventually use the iTK in armored vehicles, tanks, and aircraft.

“We are setting up a research collaboration with the Ryder Trauma Center in Miami,” Salinas said. “They have a vehicle safety research center, and we would like to incorporate this technology into the vehicle safety system such as airbag deployment sensors. So you will have a seatbelt to protect your body and built in tourniquets that will automatically deploy to keep you from bleeding out if you are injured during a vehicle accident.

“Tourniquets have been proven to be effective in the battlefield, and this is the future of tourniquet technology,” said Salinas. “As we continue to support the current conflicts and prepare for any future operations, the need to have reliable and effective hemorrhage control devices such as the iTK will be critical to reducing mortality rates.”