Subjective vs Objective: Choosing Medical Gear

Left to right: SOFT, ETQ Wide, CAT.

July 20, 2023
Let me disclose some facts up front.  I have had a professional relationship with Tactical Medical Solutions for many years.  Lone Star Medics nor I sell any products from any company.  Lone Star Medics is a training and consulting company; not a retailer.  Also, I do not receive any monetary compensation from any company whose products I demonstrate or provide my students to use in my classes.  I purchase most of our training aids on my own. On occasion I do receive products from companies at discounted prices or for free to allow my students to use in my classes so they gain familiarity with products from various retailers and manufacturers.  My comments and opinions below are mine alone and do not represent any other company or their associates.      

Here’s the deal on the “ETQ” from SnakeStaff Systems or any new tourniquet that comes to market for that matter.  In the medical field, especially the pre-hospital emergency medical community, we base our decisions on facts, science, and data.  We do not rely on anecdotal or subjective opinions or theories alone.  We use what we refer to as “evidence based medicine.”  So when we look at tourniquets or any other life-saving medical device; we want to review all the data, peer reviews, research conducted by third-parties, etc.  Then we can make a decision about recommending that device or not. 

“ETQ Wide” from SnakeStaff Systems.

One of the groups who reviews such data is the Committee on Tactical Combat Casualty Care (aka CoTCCC.)  This committee is made up of doctors, nurses, medics from the military medical community.  They produce guidelines and make recommendations for service members of the US military for both non-healthcare providers (think, regular soldiers who are not medics), actual military healthcare providers (think, combat medics/corpsmen, and even at the military doctors/nurses/physician assistants levels.)  So when CoTCCC says something, those of us in the pre-hospital emergency medicine community listen to what they have to say.  CoTCCC is a leading authority on pre-hospital emergency trauma medicine for combat conditions.    

As of right now, there are only a handful of TQ’s that CoTCCC recommends (they don’t “approve” a damn thing… words mean things.)  In order to make that list of recommended tourniquets, there are all sorts of studies they review and data that gets crunched.  There have been several TQ’s out there on the market that do not pass reviews that CoTCCC conducts.  There are even some studies which prove certain designs or materials of tourniquets have an impressive failure rate.  For example, we know through analyzing data and tests that TQ’s made with elastic materials have an unfavorable failure rate; tourniquets like the “SWATT” or the “TK4.”  Tourniquets that are narrow or that do not have a mechanical advantage such as a windless or ratcheting mechanism do not occlude arterial blood flow (the entire point of a tourniquet) which again provides a substantial failures in occlusion.  So sometimes there may be no data proving a TQ works or not, but we do have data proving certain designs do not work.  That’s where the “ETQ” falls into.  Its narrow design and lack of data should cause pause about adding it to your medical gear lineup for now. 

There are either no studies, third party reviews, or data proving that the ETQ works or not.  We do have proof that TQ’s with narrow bands fail to occlude blood flow and that in some cases they can tear tissue (think, muscle and/or fat tissue.)  Both are bad and not character traits we want in a tourniquet.  Either way, we really do not know anything about this tourniquet other than there is no evidence that it works and that the primary band is narrower than what CoTCCC recommends for effective tourniquet use in a pre-hospital settings.

As frustrating as it is I am surprised to see such a cult following of the CAT and the new ETQ.  Everything SnakeStaff Systems claims their ETQ does better than a Combat Application Tourniquet (aka “CAT”) from North American Rescue; a “SOFT” (an updated version of the previously tourniquet known as the “SOFTT-Wide”) from Tactical Medical Solutions does already… but with all sorts of peer reviews, scientific data/studies/tests proving that it works, and has been around for nearly two decades.    

Combat Application Tourniquet (CAT) from North American Rescue.

Let me put it in terms that some folks may understand.  Think of the “SOFT” as the Glock 19.  The G19 can be fielded for use in combat, law enforcement, or even excel at civilian concealed carry.  Same can be said about the SOFT.  Both have decades of data proving they work and plenty of peer reviews from leading SME’s.  They both have an incredible history of saving lives.  The SOFT comes from an established company with an exceptional reputation which has been around for almost 20 years.  The ETQ is like a brand new pistol that just got released and made by a relatively unknown company.  This company markets this new pistol as the latest and greatest for concealed carry SOLELY on the feature that it is “small and fits in your pocket.”  Yet, no one has taken it to the range to see if the darn thing will even fire!  But several industry leaders and influencers in the self-defense industry and medical retail industry are advocating for the ETQ.  And since when is “small and fits in my pocket” a top character trait for a tool that is used to protect life?  Most of us choose traits such as “dependable”, “reliable”, and “proven to work” instead when choosing a defensive firearm… why would we not hold a life-saving medical device to the same standard or with the same mindset we use when choosing defensive tools?

Don’t get me wrong; I’m all for creating new tools and new ingenuity.  We need folks creating new and better devices for preserving life.  I don’t know anyone over at SnakeStaff Systems and I’m sure they are stand up folks.  I admire them for even attempting to come up with a new tourniquet.  Their wide version has quality design traits and I expect it to do well in research and testing.  I have my own opinions and very few gripes about the wide version, but other than not having any data proving it works, like I said earlier; it seems like a good option.  However we need to use data and hardened evidence to make decisions on life-saving equipment; not emotions or antidotal semantics.

I would highly recommend the SOFT by Tactical Medical Solutions for those looking for an EDC friendly and low profile tourniquet.  When properly prepared and folded the SOFT is a proven TQ with data backing it up and provides the wearer with multiple methods of carry in civilian attire, to include low profile environments.  Like all life-saving tools, it helps to be well trained and educated on the tool prior to its use.  We are living in the golden ages of EDC medical gear and carry options for civilians.  For years I have been challenging my students to come up with outfits and allow me to show them different ways to carry quality medical equipment in a practical fashion for the occasion which the outfit is required.  Mission dictates gear, but it also dictates how that gear is carried.  Evidence-based medicine is a thing. 

Drink Water,
-Caleb Causey

SOFT from Tactical Medical Solutions.