The C-A-T® Tourniquet: The Gold Standard

The North American Rescue Combat Application Tourniquet (C-A-T®) is one of the most widely issued and TCCC-recommended tourniquets in the world, its proper application is a fundamental skill.

Anatomy of a Lifesaver: Deconstructing the NAR C-A-T® Gen 7

The C-A-T® is a battlefield-proven device, and understanding its components is the first step to using it effectively. The Gen 7 model is the result of years of refinement based on real-world data and is a CoTCCC (Committee on TCCC) recommended device. Its design is simple, robust, and optimized for rapid, one-handed application.  

The key components begin with the self-adhering band, a strong nylon strap that routes through a friction adapter buckle to secure the device around a limb. The central mechanism is the windlass rod, a durable polymer stick that provides the mechanical advantage needed to generate occluding pressure. Once tightened, the windlass rod is secured in the windlass clip, a C-shaped holder that prevents it from unwinding. The windlass strap, a grey or white velcro strap, is then wrapped over the clip to provide a final layer of security and to write down the time of application.  

Understanding these parts is crucial for proper use and for identifying counterfeit devices. Genuine North American Rescue products have specific molding marks, high-quality stitching, and durable materials. Counterfeits often use flimsy plastic, weak stitching, and velcro that fails under pressure, which can lead to catastrophic failure of the device when it is needed most. Sourcing tourniquets from a trusted, expert-curated supplier like ViTAC Solutions is the first step in ensuring you have a genuine, life-saving tool.

Pros and Cons of the C-A-T® Gen 7

• Pros:

  • Proven Effectiveness: It is the official tourniquet of the U.S. Army and has been proven 100% effective in occluding blood flow in both upper and lower extremities by the U.S. Army's Institute of Surgical Research.  

  • Ease of Use: The single-routing buckle and intuitive windlass system make it one of the easiest and fastest tourniquets to apply, especially with one hand.  

  • Widely Recognized: As the most common tourniquet in military and civilian service, many responders are already familiar with its application, simplifying training and use in a team environment.  

• Cons:

  • Bulky for Storage: Its rigid components make it slightly bulkier and more awkwardly shaped for storage in compact kits compared to some other models.  

  • Potential for Clogging: The hook-and-loop (Velcro) strap can potentially become clogged with mud, sand, or other debris, which could compromise its ability to secure the windlass.  

  • Material Concerns: Although rare and largely addressed in the Gen 7 model, the plastic windlass has faced criticism and anecdotal reports of breaking in extreme cold or under heavy stress.  

High and Tight: Applying the C-A-T® to an Arm or Leg

The correct application of a C-A-T® to a casualty follows a clear, systematic process. The guiding principle for placement is "high and tight." This means placing the tourniquet as high up on the injured limb (arm or leg) as possible, directly on the skin if possible, not over bulky pockets or gear. This ensures the tourniquet is placed proximal to any potential injury and on a location where arterial compression is most effective.

The step-by-step process for a single rescuer applying the C-A-T® to a casualty's limb is as follows:

First, route the red-tipped strap around the limb and through the buckle, pulling it as tight as possible to remove all slack. A common mistake is not getting this initial wrap tight enough.

Second, secure the strap back on itself.

Third, twist the windlass rod until the bleeding stops completely. This will be painful for the casualty, which is a sign it is working. Do not stop turning because the person is in pain; continue until the bleeding is controlled.

Fourth, secure the windlass rod in the windlass clip, locking it into place.

Finally, wrap the time strap over the clip and write the time of application on the strap with a permanent marker. This last step is critical information for the next level of medical care.

Reassess, Reassess, Reassess to ensure the bleeding has stopped and there is no distal pulse.

Saving Yourself: C-A-T® Self-Application

The ability to apply a tourniquet to yourself is arguably the most important trauma skill you can possess, as the first person available to treat your injuries is you. The C-A-T® was specifically designed to facilitate one-handed application, but this requires dedicated practice.  

For self-application to an arm, the C-A-T® must be pre-staged correctly.

The strap should be passed through the buckle to form a loop that can be easily slipped over the injured arm.

After sliding the loop "high and tight," use your good hand to pull the strap tight and secure it.

Then, using your good hand, turn the windlass until the bleeding stops. You may need to use your teeth or brace the windlass against your body to get enough leverage.

Once tight, secure it in the clip and apply the time strap.

For application to your own leg, the process is similar but uses two hands. Slide the pre-formed loop up the leg, or if necessary, un-route the strap completely, wrap it around the leg, re-route it through the buckle, and pull tight. Use both hands to turn the windlass until bleeding is controlled, then secure it. These are not intuitive skills. They must be practiced regularly with a dedicated training tourniquet (never practice with your life-saving, "go-to" device) to build the muscle memory required to perform them under the extreme stress of a real injury.

Be prepared. Be Confident.