Velocity Systems

Video Depicts RATS Tourniquet Efficacy Comfirmed by Doppler 

There has been a great deal pushback on the Rapid Application (RATS) Tourniquet since it was released several years ago. Critics have been asking to see it used in conjunction with Doppler Ultrasound in order to prove its efficacy. What the Doppler does is determine whether blood flow has actually stopped after Application of the Tourniquet. In this video, inventor Jeff Kirkham demonstrates just that.

Jeff Kirkham is a Special Forces NCO with over 28 years of active and Guard experience. In fact he still serves in 19th Group. He’s also served as a DEA special agent.

ratsmedical.com

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49 Responses to “Video Depicts RATS Tourniquet Efficacy Comfirmed by Doppler ”

  1. Ian McDevitt, EMT-P, CCEMTP says:

    The RATS is now being introduced to Vatican Security Forces thanks to Jeff’s donation and recent training in Rome conducted by WARTEMS Staff (We Are Tactical Emergency Medicine), also Carabineri, Italian Military Command Staff PSD. Also “Good Guys in Bad Places” has access to them thru WARTEMS. Thank you Jeff for the donation and the support.

    • Jeff Kirkham says:

      You are very welcome.
      We are all about supporting the community, there is no reason that a device needs to be over priced and limited in availability.
      Anything that we can do to support you or any other group in the community we will bend over backwards to do so.
      Thank you
      V/R
      Jeff Kirkham

  2. Mehmaster says:

    Seems easier to use than the cat or sof-t,……. For auto erotic asphyxiation. All jokes aside I would like to hear from combat medicine guys why this is an improvement over the cat or the sof-t.

  3. Owen says:

    Multiple camera cuts but cant find someone to hold the doppler in place throughout the test? Why not have your “medical device” peer reviewed by professionals?
    Why is the RATS “tourniquet” only spoken positively of by people who also sell them?

  4. jbgleason says:

    The issue is NOT and NEVER HAS BEEN whether or not it will stop bleeding. Frankly, I am getting a bit tired of these guys marketing efforts. This isn’t some whiz bang bottle opener to go on your IBA. It is a life saving medical device and the manufacturer should present and market it as such.

    I can stop bleeding with a boot lace but that doesn’t make a boot lace a good tourniquet. I am likely to cause long term damage to the patient by using that method. The issue has always been, and I brought this up face to face with these guys several SOMA’s ago and they deflected, that the device is thin and will likely produce a ligature effect causing muscle and nerve damage. Especially in a long term application. FWIW, SOF Medicine is largely focused on extended care scenarios these days as things move further and further out.

    But we don’t know because they won’t submit the device for any serious peer reviewed testing. So until they get serious and show me some science, I will continue to state that I am very wary of this product.

    • d says:

      Where’s the “like” button?

    • JJ says:

      This is exactly why we issue SOFTT-W. I’ll continue to handing them out to everyone that turns up carrying a RATS.

    • Jack Griffin says:

      Bingo.

    • Jeff Kirkham says:

      Hello
      I have never met you “face to face” or otherwise but I would like to.
      Please feel free to contact me with any questions or concerns that you have I would be more than happy to address any concerns that you have.
      Thank you
      Jeff Kirkham

      • jbgleason says:

        I met your representative and spoke to you on his phone. I asked for a study, some science or peer review and got nada. Address the issue regarding the ligature. At occlusion pressures what kind of PSI are you exerting on the tissue? THAT is what medically trained personnel want to know.

        • Jeff Kirkham says:

          jbgleason
          Iam not quite sure where your ire is coming from? To my knowledge we have never spoken so I am not sure who you spoke to … maybe one of my dealers?
          There are literally hundreds of RATS dealers and tens of thousands of RATS in use world wide.
          A cursory search with google will get you the information you want, the study perfumed by Ft.Sam and lead by Ret. Col Kragh is not hard to find if you truly want the information.
          The same study clearly states that the RATS performed as well as the standard issue tourniquet. Additionally you will find no study that says the RATS is not suitable…… so far just opinion based in large part because the RATS does not “look” like a standard tourniquet.
          Medically trained personnel all over the world use the RATS. I am not quite sure where your angst is coming from. I would be happy to send you (or anyone else) out a sample RATS so that you could test it out for yourself.
          The ligature question is a good one, but not an issue. If you take 5 minutes with a RATS you will be able to see this for your self, there is no cutting, pinching, etc …. just a very strong squeeze. The material works exceptional well avoiding pinching and the rebound on the elastic material keeps the RATs snuggly in place …. even if the muscle contracts and relaxes. This is particularly important if the muscle relaxes (patient goes unconscious or pain meds) which could cause re bleed. So the trend seems to point towards elastic tourniquets.
          If you have any other questions please feel free to contact me.
          V/R
          Jeff Kirkham
          [email protected]

          • Andrew says:

            Jeff,

            “A cursory search with google will get you the information you want, the study perfumed by Ft.Sam and lead by Ret. Col Kragh is not hard to find if you truly want the information.
            The same study clearly states that the RATS performed as well as the standard issue tourniquet. Additionally you will find no study that says the RATS is not suitable…… so far just opinion based in large part because the RATS does not “look” like a standard tourniquet.”

            Are you referring to this study? https://www.ncbi.nlm.nih.gov/m/pubmed/27045491/

            “CONCLUSION: All three tactical tourniquets showed substantial capacity for hemorrhage control. However, the two new tourniquet models (RATS and TMT) did not offer any improvement over the C-A-T, which is currently issued to military services. Indeed, one of the new models, the RATS, was inferior to the C-A-T in terms of speed of application and simulated loss of blood. Opportunities were detected for refinements in design of the two new tourniquets that may offer future improvements in their performance.” -Preliminary Comparison of New and Established Tactical Tourniquets in a Manikin Hemorrhage Model. 2016

            • Nattydreadbushdoc says:

              Wonder why he never responded to you…
              SOFT-T(wide) Immediate Action TQ
              SWAT-TQ Remedial Action TQ

    • Chris says:

      Don’t dare say this on their Facebook page, it will get deleted and you will no longer be able to post. They hate any criticism (bad marketing) and use the same old tired ” but an unnamed SOF guy used it once and it worked”. I say the same think, I can show where an improvised TQ worked once or twice, does not mean it works every time.

      • Jeff Kirkham says:

        Hello Chris,
        I take exception to your comments, I have never banned anyone off the RATS Tourniquet FB page …. simply not true.
        The unnamed SOF guy you mention is actually numerous testimonies on both our web page and FB page. Feel free to go to the site and read them.
        If you would like I would be more than happy to send you several pages of testimonies of people that have used the RATS in real world applications.
        V/R
        Jeff Kirkham
        [email protected]

        • Chris says:

          You are correct, I should have prefaced with your primary distributer RE Factor did delete my and many other comments from their Facebook page. This was done when myself and others mentioned the TCCC Approved language that was one the RATS for several years until the TCCC Committee had the USPTO revoke the Trademark. Had that revocation not occurred, would the RATS still use the misleading advertising?

          If I were you I would discuss RE Factor’s interaction with those on their page discussing your product. Most people I talk with and teach think the RATS is an RE Factor product. Even shops that sell the RATS think RE Factors marketing ( and possibly by extension yours, based on what you tell RE Factor) is shady.

          I do not need pages of testimonials, I believe in evidenced based medicine and independent third party testing. As said by many I can show testimonies of improvised TQ’s working, does not mean they are reliable. The only third party testing that anyone has seen is what Andrew above mentioned and it does clearly say it is inferior to the CAT.

          But mostly the shady marketing tactics early in the life of the RATS is enough for me and many others. You allowed this and many in these communities will not forget this. It was deceitful and wrong.

          I appreciate you coming here and discussing these things.

    • Mike Nomad says:

      Thanks for getting to the… heart of the matter. The 2013 paper, “Tourniquets And Occlusion: The Pressure Of Design” compares the windlass-type CAT to the wrap-style SWAT-T, and threw a pneumatic for good measure. The important points were w/r/t completion & occlusion pressures, and muscle tension. The SWAT-T was more effective through lower generated pressure levels (so, less damage done through use).

      To step away from reading and move into actual use, I find any windlass-style tourniquet to be problematic when getting to what I consider worse case: Self-applied, single-handed. Since I have yet to deploy this stuff with my hands covered in blood, dirt, shit, etc., concerns about slippage under worse-case are why I don’t carry a SWAT-T. But, we were talking about the RAT…

      Looking at the RAT, it appears to address the complexity/stress/gross motor skills vector that I find problematic with windlass-style tourniquets. However, the RAT’s combination of their particular cleat and the narrowness of the material/tubing used looks painful, and should lead to worse _overall_ performance than any windlass-type tourniquet. So, it looks like they made a trade-off, with deployment being the top priority.

      However, the advantage of the RAT has existed elsewhere, in the tourniquet I have carried for years: The TK4L. Easy to deploy single-handed, the band/material is as wide as any current windlass-type, and I can create something of the wrap effect similar to the SWAT-T.

  5. Bill says:

    It will work, that was never a question. But, it isn’t the best tool out there and if you had to put it on yourself, by yourself, while bleeding, you will have issues.

    • Jeff Kirkham says:

      The hallmark of the RATS is use under stress.
      There seldom if ever is a “single/only” option. The RATS is super simple to use even when under the most high levels of stress.
      There is nothing to break, nothing to misroute, and requires only gross motor movements.
      If you have any questions feel free to contact me.
      [email protected]
      Thank you
      V/R
      Jeff Kirkham

  6. PTMcCain says:

    My instructors who are either experts in trauma medicine or combat emergency medicine all have warned off on the RATS torniquet. I am going to trust their opinion more than the evaluation of the makers of this item.

    While it is nice and all the RATS tourniquet is being donated to the VATICAN, the last time I checked they have not required the use of a tourniquet for a very, very, very long time.

    Sorry guys, this ain’t going to work.

    If you want us to have more confidence in this product, have it independently tested and verified by trauma and combat emergency medical and combat medics.

    • Jeff Kirkham says:

      Hello
      The RATS has been tested by Ft. Sam Houston. The RATS has also been used both domestically and in combat zones by numerous combat and civilian medics who have verified that the RATS not only worked but worked well.
      If you have any questions feel free to contact me.
      V/R
      Jeff Kirkham
      [email protected]

      • Andrew says:

        Jeff,

        Can you release the FT. Sam Houston results publicly? Thanks.

      • Weaver says:

        The constant refrain of “has been tested by Ft. Sam Houston” is right up there with “tested by Navy SEALs” on knife advertisements – meaningless.

        Tested means just that – tested. Not approved, not met high standards, not on the CoTCCC or C-TECC lists of good gear. Just that someone on Ft Sam once tested it somehow.

        Unless and until it is recommended for use by CoTCCC or C-TECC, I’ll pass – and I’ll urge everyone else to pass as well.

  7. Homer says:

    Maybe it worked in this demo because the patient has a great tactical beard.

  8. Rayforest says:

    Great to see but why now? Why did it take so long to do the one thing the community asked for? It makes this look suspect as a result.

    • Jeff Kirkham says:

      Hi Ray
      Great question … the reason I waited as long as I did was simply because I was under the false impression that other doctors doing the doppler would suffice. That clearly was a mistake, multiple MD have done a confirmation with doppler but it was not accepted by some in the community. They demanded video so I gave it to them.
      I decided to purchase a doppler myself to satisfy any questions instead of relying on other persons. This is actually the second doppler video that has been done and will not be the last.
      If you have any other concerns feel free to contact me.
      V/R
      Jeff Kirkham
      [email protected]

  9. Jeff Kirkham says:

    Hello to All
    If anyone has any questions please feel free to contact me directly. I apologize in advance that I may miss some peoples questions here on Soldier Systems but I will try to.
    RATS mission is one thing and one thing only …. provide quality equipment to people that need it.
    We have and will continue to bend over backwards to support the community and the great folks that are training them. We believe in your mission and more than that we believe in you the people behind the mission.
    I am here to serve in anyway that I can.
    Thank you
    V/R
    Jeff Kirkham

  10. P.J. says:

    I’d rather see how well it stops the pulse self-applied, one-handed. That’s much more useful to know than how it works in the best case.
    Regardless, the whole “TCCC approved” thing convinced me to stay away.

    • Chris says:

      Show me one-handed without manipulation of the injured arm. You must move the injured arm in order to apply one handed.

      The TCCC Approved misleading advertising was the deal sealer for me as well.

    • jbgleason says:

      I wasn’t even going to get into that whole “TCCC Approved” thing. It’s telling that they only stopped when they came damn close to being sued into oblivion.

  11. gilk10180 says:

    Personally I EDC one of these every day.
    Its extremely easy to carry, 100% of the time, can I carry a CAT or a SOFTT-W? Yes, but the best TQ is the one I am able to conceal on my body 100% of the time. I think its use for pediatrics and for k9 application is exemplary based on the simple fact that I will always have it on my person. I have no issues whatsoever putting it on any part of my body, single handed. I have worked in FIRE/EMS for 20 years, 12 of them as a Paramedic, I know my way around trauma and medical equipment, I just hate to see an item of value shit on because poor marketing decisions have been made.
    It also excels when our family travels out side the country, a RATS doesnt garner a second look from any one at customs or anyone who sees it. I get what everyone is commenting on, but I think we could all agree on the benefits of the device as a niche EDC item, that has its pros and its cons just like every other piece of equipment on the market.

  12. Darkhorse says:

    RATS! Always seems to be drama surrounding this product. And no, I don’t need to email you with my concerns.

    A product like this exists because of people who don’t know what the fuck they’re doing that buy into it. Folks that are high speed internet and Instagram commandos like it because it’s small, simple, and light. Plus, it makes their costume complete so that they look legit (no real commando runs without a TQ for example). And they will never, ever use it for real so who cares? This product has been given just enough life to survive but lacks the merits to be successfully implemented by SOF.

    THE PROBLEM IS: people who will slap a TQ on anything because they have NO TRAINING but carry one of these because IT’S COOL. YES- it can cause damage in a big way. That’s why it’s NOT a SOF common to all item.

    I mean this guy NO disrespect. I wish him well. Just might be time to invent something better than the current SOF issued TQ rather than continue to push this as a solution.

    • Alpha2 says:

      Darkhorse, think you hit the nail on the head alot of these dudes on IG just use it to complete the “look” and not only have no idea of how to use it properly but also probably have no intention of ever using it.
      In regards to the RATS I always think something is better than nothing than again I am no trauma or combat medicine guy so I cannot vouch for the efficacy of it. I myself have a CAT in both my vehicles, at home and in my daily bag.

    • Mike says:

      So basically you’re saying if it isn’t the best solution for the SOF community or you it’s worthless and has no real place in the market. The market for TQ’s is much bigger then just SOF and Darhorse. RATS is just one more tool in the tool box. Here’s the upside of RATS. It works, it works on adults, it works on kids, it works on animals. To top it off, it’s less then half the price as the other commonly used TQ’s. For a LE agency with a limited budget, they’re a great option. You can issue each person 3 RATS for the same price as 1 CAT or SOFTT. Better yet I can put 1 CAT or SOFTT and 3 RATS in the hands of every cop for the same price as 2 CATS or SOFTT. I just doubled the amount potential people they can treat for the same price because I decided to use a product that was not “successfully implemented by SOF” but at the end of the day it will accomplish the same mission.

      Some guys are bringing up potential issues because of the narrow bands and extended periods of time till the patient receives treatment. Once again not a real issue for the LE scenarios here in the US. When I brought the question up to a trauma surgeon he said, it’s a none issue because here in the US most trauma patients will be in the ER in less then 30 minutes, realistically more like 15-20 minutes. So as long as you’re not using a shoelace we shouldn’t run into any problems. There will be exceptions, but for the most part he’s right.

      So, like I said, just another tool in the tool box. Because it’s not the best option for some doesn’t mean it’s not a viable option for others.

      • Gilk10180 says:

        ^^this.

      • Darkhorse says:

        A tool that’s been proven to cause damage, even when properly utilized, being utilized by people with little to no training- is what it is.

        This isn’t a back up iron sight so no, it’s not just another tool in the tool box. It’s been shunned because it’s inferior with the exception of people who, like you, see it as another tool.

        And it gained traction and got visibility because of people who are untrained, unskilled, and not in the know.

        • Jeff Kirkham says:

          Darkhorse
          You are misleading people.
          Saying that it is “Proven” to cause damage goes against your previous claim that RATS has never been tested.
          I wold love to see what your referring to when you speak with such authority.
          RATS got traction from everyone from medical professionals to simple farmers for one simple reason, it is easy to use under stress, even extreme stress… In the dark, under fire. It is really quite simple.
          It was actually “people who are trained, very skilled, and certainly in the know” that pushed me to to try and get it out to people.

          Thank you
          Jeff Kirkham

          • Darkhorse says:

            My comments are based on medical professionals from the unit in which I served stating repeatedly that this device is complete garbage, not reliable, and that it CAN cause muscle and tissue damage (their words not mine).

            They have also stated that RATS has been thoroughly evaluated (not at Ft. Sam) and deemed complete garbage.

            The fact that SOOOOOOOO many people jumped on the comments section here to express their thoughts/concerns for your product should be a wake up call to you.. that the vast majority of SOF thinks it’s crap and even non SOF commenters here think it’s crap.

            I’m not misleading anyone. You’re the one who’s peddling an inferior product and spit shining a turd.

        • mike says:

          Darkhorse,

          If you’re going to make these claims about the product at least back it up with some evidence. What damage are you talking about? The possible issues with this TQ I addressed with an actual surgeon who says it’s not a realistic problem for the vast majority of TQ uses here in the US. We are not talking about a TQ for a 3 hour knee surgery. Were talking a trauma patient who will be in a hospital within 30 minutes in most cases. A patient who might be a 2 year old that my SOFTT or CAT is pretty much useless on. So please explain your answer so I’m “not in the know.”

  13. Av willis says:

    A lot of the rationale behind this product over windlass driven systems is ease of carry, but the combination of flatpacking and the phlster TQ carrier means that for a little more than the space of a belt loop, I can carry a softt- w without issue and have a battle proven design at my neck and call. With that in mind, setting aside questions of credibility, the system seems to be a solution in search of a problem.

  14. BobRoss says:

    There is obviously a massive amount of skepticism around this device as well as a massive marketing push by the manufacturer. That being said the marketing has been primarily geared towards the above alluded to “instagram gunfighter” with their consumer habits based merely on a page with more followers. These individuals now purchase something prior to fully understanding the application, risk vs. benefit and frankly any of the medicine behind hemorrhage control.

    IF this device was truly designed for SOF professionals and professional rescuers then this company’s initial marketing strategy would not have been to mislead its entire customer base by stamping words “TCCC APPROVED” on their “tool” tourniquet may not be the right word. Knowing full and well that this was inaccurate and allowing the myth to continue and allowing individuals to purchase this device as a Lifesaving device, and trusting that the presumed approval was legitimate.

    The ecosystem of accessories surrounding the rats tourniquet are novel and a little cool. But could this money spent on nylon products possibly gone to 3rd party evaluation or if not at least creating reputable data driven backing for the claims made.

    There has yet to be a published range for pressure gradient after application, pressure lost at intervals, blood loss over a period of time, known complications after application. I.e nerve damage, compartmentalization, etc. Plus the assumption of multiple wraps equals a 1.5 inch band. This has been debunked through training alone.

    I think it is fair to say that prior to any true professionals adapting this product we want data! I don’t want a google search I want a PubMed or reputable database search to populate data for this “device”. Evidence Based Practice is only as good as the evidence, if there is no evidence it does not get put into practice. That simple. Now that being said if the evidence is as profound as the claims, I would absolutely consider utilization but only after legitimate proof. Sam houston loves to publish! So after their testing is complete maybe it will be included in future documents published by NAMRU or other units of of JBSA.

  15. Chris,

    Chances are you were deleted because you weren’t simply asking a question for information, you were more asking it to start an argument or discredit the item. We have a lot of people that simply get on and trash the RATs Tourniquet and they in turn get banned. If you don’t like the RATs Tourniquet, then feel free not to buy it. The TCCC language issue was resolved a long time ago, so bringing it up as a way to discredit the item does nothing.

    Again, your entire rhetoric above is about how you wont use the RATs, which is fine. Plenty of other people are happy to use it and we get emails almost every week where someone used it and it saved their life. In fact we received this email on Friday:

    “Dear Sirs,

    A couple of months ago I ordered 2 red RATS tourniquets, one for myself and one for my wife to put in our every day carry stash.

    When I got the package you had sent me 3. Instead of letting you know (I know I am a shitbag) I gave it to a buddy of mine who is usually out doors, and didn’t have one.

    Friday, I received a text from him saying he just used the RATS that I gave him. He told me that he had just left the shop, and witnessed a car run a red light in the left turn lane and T bone the car in front of him. He jumped out of his truck, ran up to the car in front of him and the driver’s arm was completly shredded half way up the forearm. He had arterial bleeding. My buddy quickly ran back to his truck grabbed the RATS, and applied it, and then marked T1502 just like we were taught during CLS. He also wrote his phone number on the guys arm for the DR/EMT’s because he had to leave for his 2nd Job.

    The EMT called him a little while later and told him good job, and that he saved that mans life.

    It may seem like a mistake, or a coincidence, but had you guys not sent an extra RATS, I would never have given it to my buddy, and he never would have had it to stop the blood flow of the driver in front of him who got T boned.

    Thank you very much”

    The issue is when someone gets on and starts to discredit the RATs it starts a firestorm of other haters, who know nothing about medicine, tourniquets or even the product. The questions people ask are questions they already know have been asked and answered by either RATs or ourselves. But they still ask the question that has been addressed over and over to join a hater feed rather than try and get actual information.

    All that aside if you would like to have information answered on the RATs feel free to email us or even call us. I’d be happy to answer any questions you have that you feel are being addressed in a shady manner.

    • Jeff Kirkham says:

      Thanks RE Factor.
      I had not heard this story you copied above.
      It is always incredibly humbling to hear that my invention has aided in saving a life..
      Thanks Gentlemen, just made my day!
      V/R
      Jeff Kirkham

  16. Jeff Kirkham says:

    Quoting -Kyle Sims-
    As an author of TCCC Guideline Change 15-03, I am very familiar with the process for “approval by the CoTCCC.”
    The existing tourniquets have been approved based on testing by the ISR in 2004 and no updates have been made to the list since.
    This is despite multiple generations of each of the approved devices presumably to correct issues related to end user complaints about the perofrmance of the device or potential errors in use and technological advances in materials.

    Both the CAT and SOF-T are very different products than they were more than a decade ago when there were very few solutions available. I have used both extensively and neither is perfect this is why they have continued to innovate for the last decade in relative luxury of only haveing to compete with each other.

    This deference to the committee for procurement advice creates a situation where you are
    unable to get your device evaluated as there is no clearly defined set of standards for a product
    to meet and scheduled review or application process. This, as often happens creates a barrier
    to entry and an artificial monopoly.

    It has frustrated many of us in the community for years including the committee itself. How can the committee review products when a company cannot successfully enter the military market without approval by the committee?

    THIS IS NOT WHAT THE COMMITTEE WAS SET UP TO DO and if the day ever comes when the TCCC
    Guidelines become doctrine, all mention of individual product names will be dropped from
    these guidelines.
    This will actually be a blessing to them since I know they do not like the pressure this brings from industry or the services.

    I am a consultant for SAM Medical and a retired Medical RDT&E SM and Special Forces
    medic.(this allows the reader to take what I have written with a grain of salt and verify the
    content of the information I have provided) Despite my current employment, I have close
    personal friendships with many in the community including North American Rescue, Tac Med
    Solutions, the ISR, the CoTCCC, SAM Medical and the service members that carry all the life
    saving equipment we work hard to produce.
    – Kyle Sims –