A tourniquet is not a device, it is a philosophy! A philosophy that when used in the pre-hospital setting has saved thousands of lives in the past decade. Commercial tourniquets have proven to be superior to improvised, but whatever your planned intervention we know that we all have to “See Something, Do Something” and “Stop The Bleed”. Many tourniquets have the ability to achieve arterial occlusion and some tourniquets have unique advantages. For this article we will talk about the – Stretch Wrap and Tuck – Tourniquet, also known as SWAT-T.

Bleeding control – A paradigm shift

With 40+ case reports from the field and 10+ published research studies and credible testimonies, we will specifically speak to where the SWAT-T has proven advantage over the windlass / strap / ratchet style tourniquets:

• Offers occlusion at lower / safer pressures

• Equally effective at achieving occlusion, and more effective at maintaining occlusion

• Effective with significantly less pain (due to circumferential distribution of pressure)

The SWAT-T has saved lives after windlass/strap failures in:

• Pediatric – civilian and battlefield applications after failures of other tourniquets (due to small limb size and pain related to applications)

• Canine – both police and military working dog applications after others failed (strap/windlass would slid down conical shaped limbs when tightened)

• High axillary wounds – including 2 US Border Patrol saves after windlass failure

• SWAT-T can be effectively applied above the shoulder/deltoid

SWAT-T is used as an all-purpose wrap and occlusive pressure dressing. As stated by a USN SEAL, “the SWAT-T is the ultimate trauma multi-tool”. Proven to be effective with minimal training relative to strap/windlass tourniquets.


For SOF Operators: The author recommends high quality CoTCCC recommended windlass tourniquet to be worn externally – replaced every 30 days due to UV exposure. Additionally, one or more SWAT-Ts should be kept in an IFAK, the negative space behind ballistic plate, and/or other easily accessible location.

Non-SOF/Law Enforcement/Lay persons: If you are carrying just one tourniquet, you must consider your patient demographics, the studies, and the unique advantages of the SWAT-T.


Guest Writer – S. Brock Blankenship, MD served as a USAF Pararescueman previously deploying for operations in Bosnia-Herzegovina from the 23rd Special Tactics Squadron. As an STS PJ he worked with various special operations forces from US Marine MARSOC, US Army Ranger and Special Forces, US Navy SEAL and Allied SOF. He now works as an Emergency Physician, teaches (SOF medics and physicians in training), and is the president of TEMS Solutions – who produces the SWAT Tourniquet.