Comparison of the Effectiveness of the DNIPRO Gen 2 and SICH Tourniquets Versus the CAT Gen 7 and SOFTT-W Gen 4 Tourniquets

Background and Objectives: Massive extremity haemorrhage remains the leading cause of preventable death on the battlefield and among trauma victims in civilian settings. Tourniquets are an effective, low-cost tool used to rapidly control bleeding. However, the availability of certified tourniquet models during a full-scale armed conflict can be significantly limited. This favours the emergence of locally manufactured devices. The aim of this study was to compare the effectiveness of the DNIPRO Gen 2 and SICH tourniquets with the CAT Gen 7 and SOFTT W Gen 4 tourniquets recommended by the Committee on Tactical Combat Casualty Care. Materials and Methods: The study included 51 Ukrainian medics experienced in prehospital care. Application speed was measured with a stopwatch, and occlusion success was confirmed by Doppler ultrasound. Pain was measured using the NRS, and participants were also able to provide subjective comments regarding the ergonomics and design of the tourniquets. Results: The four tourniquets tested demonstrated different occlusion success rates in arm and leg application. In upper extremity application, the SICH had the highest success rate (98.0%) and was associated with higher odds of successful application compared with the SOFTT-W Gen 4 (OR 25.14). In lower extremity application, the CAT Gen 7 had the highest rate of success (94.1%) and was 7.5 times more likely to achieve occlusion than the SOFTT-W Gen 4 (OR 7.54). The DNIPRO Gen 2 was rated most painful (Median 6), with significantly lower pain levels reported for the SICH (Median 4), the CAT Gen 7 (Median 5), and the SOFTT-W Gen 4 (Median 4). Conclusions: The DNIPRO Gen 2 and SICH tourniquets demonstrated high occlusion success rates, comparable to the CAT Gen 7 and superior to the SOFTT-W Gen 4. These findings suggest that Ukrainian-manufactured tourniquets may demonstrate comparable performance to CoTCCC-recommended tourniquets in a simulated prehospital setting.