Initially introduced to Special Operations in 2004 by North American Rescue (NAR), the Combat Application Tourniquet (CAT) was adopted into the greater US Army as the standard issue for all forces by 2005. Since then, the CAT has proven to be a lifesaving device credited with decreasing battlefield mortality rates by as much as 85%, and seen heavy use in every major theatre of operation since first issued. In this, the first part of a series, we will identify the features to legitimate CATs to better expand the end-user’s understanding.

Background

However the advent of these devices has not come without some risk. Fraudulent manufacturers (predominantly from China) have flooded the market with counterfeit variants that can pass convincingly for legitimate CATs. In the past some units and organizations have distributed fake CATs (identified as E-CATs from Hong Kong) unknowingly only to have them fail, break, or take much longer to attain occlusion of the blood flow. To combat the influx of counterfeits, NAR (and the CAT’s physical manufacturer Composite Resources) have altered the features of the CAT in sequential generations over the years, but it has become a cat-and-mouse game of trying to force retailers like Amazon or eBay to recognize and limit those overseas providers. In December 2021, Composite Resources won in a patent infringement lawsuit against Recon Medical, which had been using the CAT design with minor modifications to offer a fraudlent tourniquet prone to failure.

The purpose of this informative editorial is to identify the features of legitimate CATs (currently on its 7^th Generation) so that the consumer/end-user is better aware, and can distinguish between those and fraudulent CATs that would otherwise risk life and limb. Included in this article is a GEN 7 (2016 – present), GEN 6 (2015 – 2009), and GEN 3 (2009 – 2006) which comprise those with the widest distribution. It is not the purpose of High Ground Media to be offering medical advice or instruction. The consumer is recommended to receive proper training on the use and application of tourniquets.

Discussion

The design for the CAT has not changed significantly since its introduction in 2005. It still consists of the following elements:

• Windlass Strap: Used to secure the windlass rod inside the windlass clip and prevent slippage
• Routing Buckle: Used to route the hook-and-loop band around the effected extremity and form the basis for the tourniquet’s loop.
• Stabilization Plate: Used to provide an unobstructed point of focus for the compression band and prevent accidental pinching of tissue while tightening the windlass rod.
• Windlass Clip: Used to secure the windlass rod and prevent slippage
• Windlass Rod: A rigid polymer rod used to tighten the compression band and generate deep tissue pressure.

As of this publication, the current generation of CAT is the GEN 7, which is widely distinguished by its grey windlass strap with “Time” printed on the exterior in an Aerial bloc font. As with all genuine CATs, the windlass strap uses sonic welding to fuse the base of the windlass strap (and throughout the entire product) to the back of the windlass clip to create a solid bond. This sonic welding is apparent in that it fuses contacting fibers of nylon inside the fabric, but leaves the surface layers intact. The previous GEN 6 had the same windlass strap features, however it was white and not grey. Predating those, the GEN 3s CATs used a black windlass strap in much the same construction but without “Time” printed on the exterior.

The current routing buckle in the GEN 7 includes added features such as raised “CAT” letting on the buckle, and uses a single loop to anchor the fabric/compression band. In the GEN 7 the sonic welding fuses the fabric directly against the slightly curved routing buckle, whereas in the GEN 6 the routing buckle uses a double loop to anchor the material (without the sonic welding). As with all other original CATs, the presence of 5mm mold-markings are evident in specific locations.

Identifying features for the GEN 7’s stabilization plate are predominantly the manufacturer’s copyright data on the back of the plate. For Gen 7’s it is raised black lettering, whereas in all previous generations it was merely a white print made directly to the plate itself. As before, 5mm mold-markings are present on the rear of the stabilization plate.

As part of the front to the stabilization plate, the windlass clip on the GEN 7s were reinforced for added strength over all previous variants. Beginning with the GEN 6s, the thickness of the windlass clips was also increased over the previous GEN 3s.

The current windlass rod for the CAT 7s is both a thicker and more robust version than previous designs. It includes a raised ribbing on either end for greater tactile control, and is also slightly tapered on both sides. The same raised “CAT” lettering that appears on the routing buckle also appears on either end of the windlass rod. In GEN 6s and all those before, the windlass rod was a straight linear rod with consistent 5mm mold-markings. Moreover the windlass rod of the GEN 6s and 3s had groove cuts for tactile feel, rather than a raised ribbing.

The final identifying marks for any genuine CATs includes the lot information printed near the tail end of the hook-and-loop band. This lot information includes the month, day, and year of manufacturing, and is in conjunction with the CAT’s distinctive red tail end (although the red tail was not present on GEN 3s and prior). Over time, the format of this information has changed, with late GEN 6s and all 7s including the NSN number and other information as well. Again, the sonic welding and straight-line stitching provides reinforcement to the overall material.

Disclaimer: The purpose of this series is strictly informational, much like our COVID Chronicles, body armor, or gear guide, this series is not intended by High Ground to sway or convince the reader that one specific brand of tourniquet is superior to all the others. In the end, this series is intended to provide the reader with a condensed and focused resource—nothing more. It is not to be considered medical advice nor instruction. For proper use of applying a tourniquet, end-users are encourged to receive legitimate training from a certified instructor.

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