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Wilderness Environ Med. 2017 Jun;28(2):84-93. doi: 10.1016/j.wem.2017.01.030. Epub 2017 Apr 20.

Belts Evaluated as Limb Tourniquets: BELT Study Comparing Trouser Supporters Used as Medical Devices in a Manikin Model of Wound Bleeding.

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United States Corps of Cadets, United States Military Academy, West Point, NY (Mr Bequette).
United States Army Institute of Surgical Research, Joint Base San Antonio Fort Sam Houston, TX (Drs Kragh, Aden, and Dubick). Electronic address:
United States Army Institute of Surgical Research, Joint Base San Antonio Fort Sam Houston, TX (Drs Kragh, Aden, and Dubick).



The purpose of the present study is to compare several models of commercially designed belts as used as a tourniquet.


In the Belts Evaluated as Limb Tourniquets (BELT) study, an experiment was designed to test the effectiveness of pants belts as nonimprovised medical devices to control hemorrhage in a manikin. Models of belts included Tourni-belt, Tourniquet Belt, ParaBelt, and Battle Buddy. Data collected included effectiveness, time to stop bleeding, total time of application, pressure, blood loss, and composite results (score count of good results; composite outcome good if every component was good).


Differences in effectiveness percentages among models were not statistically significant. The difference in mean between users was statistically significant for stop time, total time, pressure, blood loss, composite score, and composite outcome. Mean time to stop bleeding differed for only 1 pair of models after the Tukey-Kramer adjustment; ParaBelt was faster than Tourniquet Belt. Mean total time of application differed between ParaBelt-Tourniquet Belt and Tourni-belt-Tourniquet Belt; the former model in both pairs was faster. No significant difference in mean blood loss measured by model was found. For composite outcome score, no pairwise difference between models was significant. For composite outcome (good-bad), ParaBelt had good results in 75% of tests; the other 3 models had significantly worse results.


In a preliminary laboratory analysis of belt tourniquet models using a manikin, performance differed by model. ParaBelt performed better than other models for the composite outcome.


emergency medical services; first aid; hemorrhage/prevention and control; medical device; resuscitation; shock; tourniquet

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