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New TCCC guidelines provide officers more tourniquet choices

The Committee on Tactical Combat Casualty Care had previously only recommended three tourniquets in its guidelines

In May 2019, the Committee on Tactical Combat Casualty Care (CoTCCC) released an updated list of approved tourniquets.

The CoTCCC had previously only recommended three tourniquets: the CAT, SOF-T and a pneumatic device called the EMT. The list below details all the approved (non-pneumatic) tourniquets. I outline my first impressions, as well as some of the benefits of each model, some of which may provide different advantages to officers in the street.

Please be aware that counterfeit versions of some tourniquets are being produced overseas. The safest course is to buy tourniquets directly from manufacturers or reputable public safety suppliers and distributors.

TMT Tourniquet Combat Medical

This lightweight tourniquet boasts a two-inch-wide strap, as well as a curved plastic frame that houses the plastic windlass. There is a single retention clip that locks the windlass into place with an audible click. The TMT also has a buckle that can be unhooked or threaded depending on the situation. On the tail, the word “Pull” with an arrow shows you which direction to pull in order to tighten the tourniquet before using the windlass. The buckle is large, connects easily and allows the tail to slide smoothly through. This tourniquet is super light and packs up really small. I like the 2-inch belt. The TMT is available for $29.95.


The TMT is lightweight, packs well and is flexible for application.

Photo/Sean Curtis

CAT Tourniquet Gen 7 by North American Rescue

The CAT has been around for a long time and is the official tourniquet of the U.S. Army. The Gen 6 is also on the approved list, but the Gen 7 has some upgraded features like a single routing buckle and a more robust windlass that is longer and thicker. This is one of my favorite tourniquets and the upgrades have only made it better. One of the best things about the CAT is that it is extremely lightweight. I wear this in a suit coat pocket, and it doesn’t weigh me down. The CAT retails for $29.99.


The CAT is a classic and the improved Gen 7 is even better.

Photo/Sean Curtis

TX2 and TX3 RevMedX

The majority of approved tourniquets consist of a hook and loop belt that closes around a limb, then back on itself before being tightened by the windlass. RevMedX went in a different direction. The TX2 and TX3 are wide straps that have non-removable slip lock rings for tightening. While they cannot be unclipped, the tail can be removed and re-threaded to get around limbs if needed. The buckle allows you to pull the tail down until the belt is tight and it does not allow the belt to loosen. There is a nylon loop that allows you to hold the tourniquet in place while you cinch the belt.

Once the tail is pulled tight, the person applying the tourniquet then begins ratcheting a buckle on a plastic, toothed strap that cinches the tourniquet down tighter until the bleeding stops. The system seems to work pretty well, and the ratcheting sound makes audible clicks with each bite it gains. Many of the tourniquets in this list are 1.5 inches wide and this was the minimum standard taught to me by my TCCC instructor. The TX2 is 2 inches wide and the TX3 looks enormous at 3 inches, but these are less painful when you cinch them down to the point of stopping blood flow. Both of these tourniquets pack down thin, but long, because of the plastic strap the buckle climbs. The TX2 is $38.95, the TX3 is $39.95.


Left: The TX2 is a unique approach with a ratcheting buckle. Right: The TX3 is so wide, it looks like something from a restraint chair or race car, though the width helps minimize the pain upon compression.

Photos/Sean Curtis

XT Tourniquet SAM Medical

I’ve used SAM Medical products for years, and the XT Tourniquet is a welcome addition. The frame is built of robust plastic and has retention wings and a hook and loop retention strap for the aluminum windlass. There is a heavy-duty plastic buckle at one end that houses a unique feature. The strap on the XT has paired holes in incremental positions. When the tourniquet reaches a sufficient tightness, two teeth deploy from the buckle with an audible click and catch the holes in the belt, locking it tight. The whole unit feels lightweight yet sturdy. The audible clue from this tourniquet may help you know when you’ve tightened it enough, but always check to ensure the blood has stopped flowing. The XT sells for $37.95


The innovative XT locks up tight and clicks into place.

Photo/Sean Curtis

SOF Tourniquet Gen 4 Tactical Medical Solutions

This has been my go-to for years. While it is a little heavier than other models, the SOF is beefy and feels like it could shut down a raging firehose. The improved buckle allows you to open the tourniquet and snake it around limbs where you can’t just slide it over the hand or foot for some reason. The clip allows you to do this without forcing you to rethread a buckle. Improvements in the Gen 4 include a new Tourniquet Retention Assistance Clip that helps hold the tightened windlass in place while you secure it with the tri-ring, which makes the SOF easier to use one-handed. Additionally, the windlass is longer and stronger. The SOF sells for $29.93.


The SOF is super sturdy and the new clips make it easier to lock in.

Photo/Sean Curtis

Saving Lives

These tourniquets all get the job done when it comes to locking down hemorrhage from a limb. Some of them offer different features or operate a little differently, but they all initially cinch down by pulling the tail tight, then following up with some secondary mechanism to lock them down tighter before securing them.

In addition, they all have a location to mark the time of application so doctors can estimate the risks of blood gasses building before they remove the tourniquets.

This is one of the cheapest life insurance policies you can carry around with you.

NEXT: Product review: 2 new tourniquets to consider

Sean Curtis is a law enforcement professional with over two decades of experience, serving with SWAT, diving and swift water rescue teams in Colorado. He has also served in wildland fire, search and rescue, EMS and emergency management.