RATS Tourniquet: Rapid Application Tourniquet System

A tourniquet that has been gaining quite a bit of popularity lately is the RATS Tourniquet. It takes a bit of a different approach than other real-world tourniquets, like the SOFT T Wide and CAT, because it uses elastic strength to stop blood flow instead of the windlass system.

This solves several of the shortcomings of windlass tourniquets, but it creates some potentially dangerous side effects at the same time.

How to Use a RATS Tourniquet

How to use RATS tourniquets

The RATS tourniquet has a metal cleat at one end and a long, elastic band made of vulcanized rubber attached to it.

  1. Start by holding the metal cleat in one hand.
  2. At the end with the cleat, the rubber band should be threaded through to form what they refer to as a three finger loop .
    1. Your limb does NOT go through the three finger loop.
  3. Place the cleat on the limb requiring a tourniquet and wrap the long length of rubber around the limb.
  4. Thread the long end of the rubber band through the three finger loop and pull until snug.
  5. Wrap the long length of rubber back on itself and continue wrapping the limb until the elastic is used up or the blood flow has stopped.
    1. With every wrap you should be stretching the rubber so that the band pulls tight and cuts off blood flow.
    2. Do not pull the band as tight as it can go because it can cause permanent neurovascular damage if tightened too much.
  6. Hook the end of the rubber band into the cleat to secure the tourniquet in place.

RATS Tourniquet vs SOFT T Wide and CAT Tourniquets

Elastic tourniquets are already standard in hospitals as surgeons use them to cut off arterial blood flow during surgery. In hospitals, however, the pressure can be carefully monitored unlike in the real world.

Every time an elastic band is stretched around a limb, it increases the pressure force on the soft tissue underneath by about 2 to 3 times depending on how far the elastic is stretched[1]. This large increase in pressure will stop bleeding fast and effectively, but the pressure can easily be so great that it causes permanent nerve and soft tissue damage to the limb[2,3].

The uncertain pressure caused by the RATS tourniquet is a problem in the field because you are allowing human error to play a part during an extremely stressful life or death scenario.

Wrapping the tourniquet too tightly could cause permanent neurovascular damage, but wrapping it too loosely will not stop the bleeding. Then, if you do not hit that sweet spot, you have to rewrap the entire RATS tourniquet which restarts the bleeding. It is better if the tourniquet’s design prevents these problems.

The SOFT T Wide and CAT tourniquets use windlasses as a tightening mechanism because they have adjustable pressure. If the bleeding is not stopped, tighten the windlass another twist until it is. Turning the windlass also becomes much harder the tighter the tourniquet is applied. This provides good feedback to the user and prevents overtightening.

RATS Tourniquet (Elastic)

PROS:

  • Very fast application
  • Inexpensive
  • High quality materials
  • Easy to stop blood flow
  • Does not loosen or slip over time
  • Has multiple functions, so users keep it close by more often

CONS:

  • Difficult to know how much pressure is being applied
  • Can cause permanent neurovascular damage if applied too tight[3]
  • Relatively new and not tested extensively by military like the CAT and SOFT T Wide
  • Difficult to apply one handed during trapped arm situations

SOFT T Wide and CAT Tourniquet (Windlass)

Sof Tactical Tourniquet Wide

PROS:

  • Tourniquet design prevents overtightening
  • Tested extensively by the US military

CONS:

  • Must check periodically after application for loosening

The Bottom Line:

The RATS tourniquet provides many improvements over other models that use the windlass style, but the possibility of permanent damage keeps me from recommending it wholeheartedly. The SOFT T Wide tourniquet is still the best and most reliable on the market.

Tips:

  1. The RATS tourniquet can be used as a bungee for a variety of other uses. This will help make sure that you always have it with you, but it could also make it difficult to get to in the event of an emergency.

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About Peter Oldani - Author of Inside First Aid

About the author

Peter Oldani graduated college with a B.S. in biomedical engineering, worked as an EMT to gain hands on experience in emergency medicine and completed active shooter training as part of New York State’s initiative to prepare civilian organizations for disaster response.