When I went through Army basic training back in 2003, things were a lot different on the medical front than they are today. The Afghanistan conflict was still fresh, Iraq had just been invaded, and there hadn’t yet been time to take in any “lessons learned” from After Action Reviews, since there had hardly been any action to review.
At the time, a soldier’s first aid kit was just as simple and bare bones as the training he received to use it. It consisted of nothing more than a sterile cotton gauze bandage attached to a piece of OD green muslin cloth in a sealed wrapper, tucked into a small, floppy pouch ALICE clipped upside down on the left suspender strap of your LBE. Instructions for new recruits boiled down to “Apply bandage. Apply Pressure. If problem persists, call for the medic.” Yes, we were taught at that time how to make improvised tourniquets from things like belts, rifle slings, strips of cloth, or whatever else we had on hand and proper placement of the TQ to a profusely bleeding extremity. But at the time, the TQ was an item that was seen as a LAST RESORT use item; something to be applied only if manual pressure and pressure dressings had failed to stop a bad bleed. It was recommended that they be applied most ideally under the care and guidance of someone CLS certified.
Times change and so to TTP’s. With the lessons learned in Afghanistan and especially Iraq, it was seen that traumatic blast amputations were one of the most common forms of severe trauma encountered thanks to insurgent’s use of IED’s on roadsides. In the two short years between basic training and my first deployment, the LC-1 First Aid Pouch ballooned into the Nerf football-sized IFAK and the tourniquet went from being a battlefield improvised tool of last resort to being one of the first things troops were trained to reach for in the even of a blast injury to an extremity. No longer would troops be expected to jerry rig their own TQ from a cravat and a stick, as specialized, purpose-built implements were developed, tested, approved for use, and issued to troops on an individual level. The CAT and SOF-T became the gold standard for treating a catastrophic extremity bleed.
While the CAT and SOF-T are both excellent designs which are easy to use, they do have a few downsides to them. For example, the CAT has a plastic windlass which some have reported breaking when enough torque is applied to it. The SOF-T, with its aluminum windlass, doesn’t have that problem. However, it does have a steel spring tensioned strap retainer which is held tight with a hex drive screw, which can be difficult to apply with sweaty, wet, or bloody hands or can accidentally be left tightened in stowage, rendering the TQ unusable until the screw is loosened. Neither situation is ideal, and in addition to these drawbacks, both the CAT and SOF-T have several areas that can snag on straps, MOLLE webbing and clothing. A company called RE Factor Tactical took a hard look at the current state of dedicated tourniquets, and figured that they knew a way to do it better.
RATS: Simplicity Made Manifest
When I first saw the RATS advertised online, the first thought that ran through my mind was “Surely it can’t be this easy. Surely this cannot be something that actually works.” I said this because I remembered in my first aid training that it was not advisable to make a TQ out of thin materials, such as boot laces and 550 cord, and that’s what the RATS looked like to me, to which RE Factor Tactical responded “Yes, it is this easy, yes it does work. And don’t call me Shirley.” Anyways, the price was right, so I decided to give it a shot, and added it to the cart. A few days later, my order from RE Factor Tactical arrived, and all my doubts were put to rest.
Though the RATS may look like a simple piece of elastic tubing in some photos, in reality it’s a flattened rubber strap about 1/2″ wide, with what appears to be woven nylon wrapped around it. It folds and compresses down to an incredibly small size if needed, and is easily deployed and tightened down. On one end is a stainless steel bar with the strap connected at one end and the other end in a notch to hook the trailing edge into one the TQ is applied to a limb. The user creates a simple loop, slips the affected limb through the loop, and wraps the trailing strap three or four times around the limb, making sure to keep the strap flat and untwisted, and keeping the wraps as close together as possible. With a little practice the RATS can be applied properly in less time than it probably took to read that last sentence. Just slip it on and cinch it down. The RATS is pure gross motor skill and brute force from start to finish, no Velcro to line up, no windlass to tighten and possibly lose rip on with wet or bloody fingers, or fingers numbed by an adrenaline dump and ambient cold, and no windlass retainers to worry about slipping loose.
In the above picture, the RATS has been secured to my arm for about 20 seconds. My hand is turning slightly blue already, and I’m trying (and failing) to make a fist. It’s that effective. Another great thing about the RATS, in addition to its low price, simplicity of construction, ease of use, and effectiveness, is it’s relatively snag-free design. Other than the steel locking bar on the end, the RATS is really nothing but a rather slick feeling, nylon covered strap, and in a pinch can be routed through MOLLE webbing if need be. And, as if all that wasn’t enough, up near the locking bar there is a small white tag, both reminding you that the initial three finger loop is supposed to be there permanently in order to pass the trailing strap through and to read the instructions before use, in addition to having a place to write the time that the TQ was applied. They really have thought of everything. The RATS is available in Red, Blaze Orange, and of course Tacticool Black (shown) for only $15.95 from refactortactical.com.
In the heat of a medical emergency, when you need a TQ, you need it *RIGHT NOW*! Although RE Factor makes their own nice carriers for the RATS, there’s another company out there that should be familiar to anyone who’s into high quality gear who has a much simpler approach to carrying a variety of tourniquets in a readily accessible manner.
Blue Force Gear tourniquet NOW! Strap: Keep it Simple, Stupid
We often hear the lamentation “That’s so easy, why didn’t I think of that!?” and BFG’s Tourniquet NOW! Strap is yet another one of those million dollar ideas where you look at it and sigh. The Tourniquet NOW! is nothing more than a simple plastic bar with a pair of strong elastic straps running through it designed to hold a CAT, SOF-T, or other dedicated tourniquets, including the RATS.
The tourniquet NOW! allows placement of a TQ anywhere on MOLLE-compatible gear anywhere ou have one column and three rows of available space on your gear. The plastic bar slips underneath the MOLLE straps while the elastic bands ride in between them. The TQ is then folded flat and stuck into the elastic bands, and the whole thing rides secure and comfortable, taking up almost no space at all. While the tourniquet NOW! Strap was originally designed for use with Blue Force Gear’s own proprietary MOLLE Minus system, it’s all reverse compatible with legacy MOLLE systems, and even works with other MOLLE-compatible systems like First Spear’s laser cut laminate 6/12 system with a minimum of fuss and no modification to either product.
Top Left: Tourniquet NOW! in First Spear 6/12 webbing. Top Right: Tourniquet NOW! in legacy MOLLE webbing. Bottom: Tourniquet NOW! in Blue Force Gear MOLLE Minus.
The Tourniquet NOW! Strap is the perfect solution for holding a TQ at the ready in an easily accessible spot on your gear. While it was originally envisioned to be used with the CAT tourniquet, the windlass keeper and tri-glide buckle on a CAT makes removing the CAT from the Tourniquet NOW! sometimes cumbersome, as they can snag on the elastic straps. With the inherent simplicity of design combined with the dead simple use of the RATS, you could theoretically stage several RATS on your gear in a minimum of space, readily available at a moment’s notice to treat a grievously bleeding extremity. It’s easy to measure out enough loop on the RATS to slip in your biggest limb, S-fold the RATS, and slip it into the elastic straps on the Tourniquet NOW! with the metal locking bar facing the most likely direction of approach for self aid. After that, the RATS stays secure and accessible, ready to be used whenever necessary. The Blue Force Gear Tourniquet NOW! Strap is available on blueforcegear.com for only $11.00, and comes in Coyote Brown, Foliage Green, Wolf Grey, OD Green, Black, and Multicam (shown). Best of all, BFG also sells the RATS on their site, so you can go ahead and purchase both these amazing products at the same time, together. Both offer an unheard of level of simplicity, low-cost and ease of use. It’s for this reason that I have two RATS TQ’s staged on my plate carrier and a third in my pocket first aid kit that goes with me everywhere.
Author – Dustin Hobbs is a nine-year veteran of the U.S. Army (2003-2012), who served three tours in Iraq with the U.S. 3rd Infantry Division’s 2nd Brigade Combat Team as a Small Arms Repairman 45B and as a Gunner and TC on Convoy Logistics Patrols, achieving the rank of SGT/E5. After a brief stint as a gunsmith, he moved back home to Nebraska, where he is currently employed by Hornady Mfg. making the Best Damned Bullets money can buy.