# Rapid Application Tourniquet System (RATS) TQ



## InNoViSiOn (Jan 27, 2015)

http://ratstourniquet.com/

I put this thread under the military subforum because it is currently still being evaluated by the committee on tactical combat casualty care.  I did a search on this forum and did not find a thread talking about this relatively new tourniquet system.  If this subject is relating to other EMS subforums MODS please move it. 

Here's a video from a squared away man with a good youtube channel - 




I finally got around to ordering one last week and hopefully will receive it soon to get some hands on practice with it myself.  The longevity of this tourniquet seems like it would be superior to the SOFTT, SWAT, and CAT tourniquets.  The TK4 FYI is no longer praised by CoTCCC and has been phased out for some time now (Although I still carry one on my person EDC because of how compact and light it is). 

I won't note the common concerns that many people have had with this tourniquet because I would like a good thread discussion on this TQ here on this forum.  

What do you think?


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## irishboxer384 (Jan 30, 2015)

Looks interesting, the thing I like about the CAT-style TQ though is it is very simple. I'm not saying this device isn't, but for something that could be mass produced for the military then it should have as little things to do as possible. 
CAT-style can also be applied with one hand, and it doesnt seem that is possible with this design. I had a colleague apply 3 himself with one hand with a CAT.

On the flip side, this device has a slimmer width, meaning more pressure meaning should stop a bleed more efficiently...in theory i guess.


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## InNoViSiOn (Jan 30, 2015)

irishboxer384 said:


> Looks interesting, the thing I like about the CAT-style TQ though is it is very simple. I'm not saying this device isn't, but for something that could be mass produced for the military then it should have as little things to do as possible.
> CAT-style can also be applied with one hand, and it doesnt seem that is possible with this design. I had a colleague apply 3 himself with one hand with a CAT.
> 
> On the flip side, this device has a slimmer width, meaning more pressure meaning should stop a bleed more efficiently...in theory i guess.



I carry CATs on the outside of my IFAK because they are indeed easy to manipulate one handed. I have SOFT-T as well but they are not as easy one handed so they are for mainly for others. There are some videos and other people stating that this can be done one handed but it doesnt seem nearly as easy as the CAT. Ill have to practice with this one handed myself to get an opinion. But one handed manipulations have been the major concern people have had with this particular tourniquet.


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## redundantbassist (Jan 30, 2015)

Looks good in theory, but would be bad in application. As you can see from the video, skinnymedic had to use a lot of fine motor skills to apply this TQ. That's bad when your patient is screaming and kicking, and even worse when YOU are the patient.


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## InNoViSiOn (Jan 30, 2015)

redundantbassist said:


> Looks good in theory, but would be bad in application. As you can see from the video, skinnymedic had to use a lot of fine motor skills to apply this TQ. That's bad when your patient is screaming and kicking, and even worse when YOU are the patient.



Good point and I agree it looks like it does require more finesse and dexterity.


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## BrodyL4513 (Jan 31, 2015)

I am about to graduate 68w school and obviously we are taught with the CAT. with that being said, we got to try out the RATS for a few days and to be honest, I like the cat better. I think it is faster to apply. My avg tq time on the x was about 25 seconds (I understand this is probably slow for all of you) but with the RATS, it actually took me longer. It could just be me but I like the CAT better


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## DRock249 (Sep 28, 2015)

Just came across this thread. Does anyone have any real-world experience with this device? I would be concerned about the narrow width causing undue pressure necrosis for extended applications.


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## wilderness911 (Feb 7, 2016)

DRock249 said:


> Just came across this thread. Does anyone have any real-world experience with this device? I would be concerned about the narrow width causing undue pressure necrosis for extended applications.



Negative on real world experience with the rats, because I passed it over for the softt and cat for exactly the reason you mentioned. I assume it would also hurt like hell for the patient. I only use tqs with a windlass as I prefer the ease of application and satisfaction of cranking the windlass down until the bleeding stops - it's like turning off a faucet. Most of the time I have actually applied tourniquets in the field, I have ended up improvising out of a cravat and a stick or other rigid windlass substitute. Never had an issue with it.

My least favorite is the swat-t, which is nothing more than a glorified and overpriced elastic bandage in my opinion. Takes forever to apply and is absolutely inferior to the cravat/stick across the board. There's my two cents.


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## Vikus (Mar 6, 2016)

Careful where you buy the RATS, lots of counterfeits online that look pretty similar.


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## beaucait (Mar 24, 2016)

Just an EMT basic, but what are some of the potential problems that come using a tourniquet that is less then 3 or 4 inches wide?
In class we learned some types of materials found on Ambulances that we could use, and they always made it a big deal to use something thicker, or else the patients arm may potentially be cut.


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## MackTheKnife (Mar 25, 2016)

I agree, from the video, that the RAT apparently takes a lot of fine motor skills and the band is pretty narrow. In real world, I've used the CAT and MET TQs. I personally prefer the MET, as it is truly one-handed like the CAT. The MET has an aluminum rectangular block for the windlass. Not sure if they're still around as I mostly see CAT TQs.


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## Gurby (Mar 25, 2016)

CaitlinBelinda said:


> Just an EMT basic, but what are some of the potential problems that come using a tourniquet that is less then 3 or 4 inches wide?
> In class we learned some types of materials found on Ambulances that we could use, and they always made it a big deal to use something thicker, or else the patients arm may potentially be cut.



I don't think this is something you should worry about.  If a patient has severed a major artery, they have already lost a lot of blood by the time you get there - just stop the bleeding ASAP.  If you don't have something like the CAT, I would use a blood pressure cuff rather than improvise something with cravats.


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## Vikus (Mar 25, 2016)

CaitlinBelinda said:


> Just an EMT basic, but what are some of the potential problems that come using a tourniquet that is less then 3 or 4 inches wide?
> In class we learned some types of materials found on Ambulances that we could use, and they always made it a big deal to use something thicker, or else the patients arm may potentially be cut.



I don't think the issue is patients being cut. I don't know what the technical term for it is, but it's basically getting much heavier tissue damage at the point at which the tourniquet is applied. Also, it's more effective using something wider (or in the case of RATS, which I don't necessarily agree with, using a wider area).


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## Daniel G (Jul 19, 2016)

Self app of a tourny is extremely painful.  This is design is good but for effective self application, it needs a better cranking/cinching system like a CAT


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## Nick Gawriluk (Aug 24, 2016)

There are so many tourniquets out in the market now and I still feel that the original designs like the CAT and SOFT are still the best. Personal opinion.


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## FireDog19 (Sep 12, 2017)

In my opinion I'm still siding with the SWAT-T. Same big points of one-handed use simplicity for the lay people but it also has multiple applications other than just as a tourniquet, such as a pressure dressing or even a sling if needed.


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## FireDog19 (Sep 12, 2017)

BrodyL4513 said:


> I am about to graduate 68w school and obviously we are taught with the CAT. with that being said, we got to try out the RATS for a few days and to be honest, I like the cat better. I think it is faster to apply. My avg tq time on the x was about 25 seconds (I understand this is probably slow for all of you) but with the RATS, it actually took me longer. It could just be me but I like the CAT better



So from my understanding aren't some units even being deployed with cats on their limbs from the get-go and just wrench down if needed.


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## Tigger (Sep 12, 2017)

Several have mentioned causing the patient pain...a properly applied tourniquet will cause serious pain and that's just a fact.


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## Jason Stopper (Sep 14, 2017)

The RATS is not a good tourniquet and has been tested by a couple of independent groups and has been shown to not completely occlude blood flow confirmed by doppler.  Its also no CoTCCC approved at this time due to the issues presented by multiple independent studies.  I prefer the CAT T as well and the agency I work at carries them in our jump/trauma kits.  

Funny story about TQ and pain.  I had a twenty-something kid who had lacerated his radial artery drinking.  A TQ had been applied but released at the ER.  I was transporting him to a higher level care facility and he kept moving the arm and wrist.  I told him numerous times to keep it still as he was going to bust the clot. He kept on so I told him if the clot busted I was going to have to resecure the TQ.  He said it was the worst pain in his life and stopped moving the hand and arm.  It is painful to the patient and if they are A&O do not stop until the blood flow is occluded.


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## CALEMT (Sep 15, 2017)

I was once voluntold to be a patient for a demonstration for a scenario. Said scenario involved a lacerated femoral artery. Staff provided a sort of "armor" around the injury site specifically for the TQ application so it could help with the pain. Long story short it didn't really help at all and that sum ***** hurt like hell. I toughed it out for the remainder of the scenario (<5 min). The CAT TQ causes an extreme amount of pain but it is effective, it left a welt on my thigh for 3 days after the application. I've seen the RATS TQ and was skeptical due to the limited surface area vs the CAT. The RATS boasts an easy application but IMHO the CAT is idiot proof and I prefer the CAT.


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## SMC (Oct 30, 2017)

I will continue to carry the CAT on my person.  If some one has yo do Buddy aid on me I want them to be familiar with the device.


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## joshrunkle35 (Nov 2, 2017)

CALEMT said:


> I was once voluntold to be a patient for a demonstration for a scenario. Said scenario involved a lacerated femoral artery. Staff provided a sort of "armor" around the injury site specifically for the TQ application so it could help with the pain. Long story short it didn't really help at all and that sum ***** hurt like hell. I toughed it out for the remainder of the scenario (<5 min). The CAT TQ causes an extreme amount of pain but it is effective, it left a welt on my thigh for 3 days after the application. I've seen the RATS TQ and was skeptical due to the limited surface area vs the CAT. The RATS boasts an easy application but IMHO the CAT is idiot proof and I prefer the CAT.



When I run a scenario like this for my agency, I have the person place the TQ, check for a distal pulse. I double check the distal pulse (to check for occlusion), and then I release the tourniquet, loosen it and leave it in place. The blood flow is occluded no more than 15-20 seconds. Maybe you could suggest something similar for the future? It’s important for your team to put it in place correctly, but that can be checked and released for the volunteer’s sake.


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## Tigger (Nov 3, 2017)

Why do we need to fully occlude flow? That sounds awful.


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## joshrunkle35 (Nov 3, 2017)

Tigger said:


> Why do we need to fully occlude flow? That sounds awful.



Because too many people use tourniquets infrequently and place them too loosely in the field and forget to check for absence of pulse.


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## VFlutter (Nov 3, 2017)

Although the RATs is inferior to the CAT in most circumstances it’s relative size makes it worth having. It is much more compact and can easily fit in a back jean pocket for daily carry. Also have one on the buttstock of my home defense rifle. The cost is another benefit as you can buy 3 for the price of 1 CAT. It will still slow hemorrhage if not completely occlude arterial flow and is much better than nothing at all until you can get to your primary med kit.


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