SAM Medical’s Junctional Tourniquet is a device that stops bleeding in life-or-death trauma situations by combining the function of a pelvic sling with inflatable modular compression devices. Smaller, lighter, and less expensive than any competing product, it’s also faster and easier to use, with successful application taking just 25 seconds or less.

The Junctional Tourniquet is already saving lives on battlefields around the world, and helping emergency medical technicians respond to serious accidents closer to home.

Due to ongoing problems with improvised explosive devices (IEDs), SAM Medical realized a growing need for a military version of their civilian pelvic stabilizer sling, which is standard equipment for emergency responders in trauma situations such as auto accidents.

Research showed that high-on-the-thigh injuries sustained in IED blasts are the number one preventable cause of death for US troops in combat situations today. The only field treatment previously available was a rigid armature and clamp that could stop bleeding, but was slow and clumsy to apply and offered no pelvic stabilization.

SAM’s civilian sling had to be completely redesigned to accommodate the new tourniquet function, and to endure the demands of the battlefield. The space limitations of a military medic’s pack demanded that the device be lightweight and extremely compact.

As for ease of use, SAM founder Dr. Sam Scheinberg explained that the tourniquet needed to be “bomb-proof and brain dead” – not because of medics’ lack of training, but due to the confusing, high-stress, life-or-death conditions in which the tourniquet would be used. Severe pelvic hemorrhage can cause death in under 90 seconds; SAM needed their solution to stop bleeding in 25 seconds or less.

Our experience with the demands of commercial product users gave us a solid grounding for designing a medical device, even one headed for military battlefields. We’re also well-versed in navigating manufacturing and financial constraints, which helped in designing a device that had to get to market fast while remaining simple to use, compact and affordable.

Our designers realized early on that their typical progression through phases of sketching and digital modeling wasn’t appropriate; all that mattered was that the tourniquet work perfectly. So they put drawings aside in favor of physical prototypes – lots of them. Early duct tape iterations progressed to sail cloth and finally ballistic nylon. We guided SAM to handle cutting and sewing in-house, while machining plastic hardware and conducting product testing ourselves. Insights gained during this collaborative process ensured the tourniquet was completed on-time and on-budget, and led to dramatic increases in functionality.

This give-and-take iterative process was unfamiliar to SAM, but par for the course for our industrial designers. Rapid prototyping allowed us to exceed the client’s expectations in a number of ways, and also helped get the Junctional Tourniquet to market sooner. Time to market really meant something, in this case: lives were at stake.

Dr. Scheinberg served in Vietnam as a MASH surgeon, and so he was able to tell our designers from first-hand experience how the Junctional Tourniquet needed to perform. We also conducted research and interviews and during ride-alongs with ex-military medics and domestic emergency first responders. The needs of these medical professionals guided our designers every step of the way, from choosing softgoods and hardware to designing graphical instructions.

By specifying several already-approved component parts, our team was able to save money and time, and put familiar hardware in front of medics. The asymmetrical design of the sling guides correct application, while also reducing pack size and lowering materials cost. Instructions for use are indelibly printed on the inside of the sling itself, ensuring usability in an emergency, even by those with no prior training.

The patented main buckle provides two distinct, audible feedback clicks on application: one for “secure” and one for “appropriately tight,” taking the guesswork out of correct belt-tensioning. Modular, inflatable bladders called Target Compression Devices allow hemorrhage-stopping pressure to be applied anywhere beneath the sling, and can be used in multiples as necessary. This flexibility means the device can used not only on the pelvis but also elsewhere on the body, including around the shoulder and on the neck, two other extremely difficult-to-tourniquet sites.

The final design underwent product testing to ensure it remained functional even under extreme conditions, such as 131°F heat for up to 90 days. SAM fabricates the compression devices to exceed US Armed Forces requirements, using high-grade materials such as Texin®, which also comprises protective eyewear, and Makrolon® polycarbonate, a component of bulletproof glass; the sling itself is ballistic nylon. This rugged design ensures that the life-saving tourniquet stays in place during patient transport, even through difficult or hostile territory, and works even in the worst circumstances.

The tourniquet is smaller, lighter and less expensive than any competitive device; functionally, it takes its entire product category a major step forward. In a review on EMS1, a forum for emergency medical services, a paramedic said of the device, “The SAM Junctional Tourniquet does things no other tourniquet can; it occludes the femoral artery in the inguinal area at the junction of the torso and legs. When blast injuries take off legs like in Boston and every day in combat zones, it can easily be fatal. It is frequently difficult if not impossible to stop the bleeding in time… A regular tourniquet encircles and compresses the entire limb. The SJT puts direct pressure on the only part of the limb that actually matters, the artery. It is well designed, ruggedly constructed, and terribly clever.”

Testing by the Army Institute of Surgical Research confirmed the tourniquet’s effectiveness, and cleared the way for deployment with US Armed Forces overseas. SAM has already received sales inquiries from around the world, and is currently stepping up production to make the Junctional Tourniquet available to save lives in dangerous situations everywhere. The device was honored with 2013’s top innovation award for new products by a panel of industry experts and EMS World.