# Sam Junctional Tourniquet



## Willie Murphy (Oct 29, 2020)

I was reading through a couple of the threads and noticed that there wasn't much talk about the Sam Junctional on here. I have only used them in training and my county was just issued them. We will surely be using them pretty soon and I was just wondering what the fine people of this community's thoughts were on them?


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## Devildoc (Oct 29, 2020)

I think they are fine as advertised.  The major issue with pelvic injuries, which I am sure you know, is that much of the bleeding in on the inside, not outside.  Not much any externally-applied TQ can do about that.  But for the high-up, hard to read, difficult to compress external bleeds, it's fine.  Regarding the use for pelvic fractures, I still prefer the old sheet-and-blanket diaper.  That's me being a troglodyte, though.


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## Willie Murphy (Oct 29, 2020)

Thanks for you input. Yeah I am more of a pack the wound and compress with half a lacrosse ball type of guy when it comes to junctional wounds so I am interested to see how these will change the game. Sprinkle a little TXA on top and who knows, maybe we can get that internal bleeding to slow down.


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## policemedic (Oct 29, 2020)

I agree with @Devildoc.  They aren’t bad, but aren’t a panacea.  We train with them using cut suits, but also train on things from packing to improvised junctional with CATs and water bottles.

The literature says the Sam is second only to the CRoC, but that depends on the study and user.  I do believe the Sam is better than the JETT and AAJT, and the literature bears that out.

The trick really is training.  The schoolhouse did a study using CLS Soldiers and 68Ws that looked at successful application of the Sam and the JETT (I’m pretty sure it was the JETT).  The results were dismal and indicated a need for additional training in both groups.  So, the moral of the story is train, train, train.  That’s especially true since I suspect in civilian settings these will get used slightly more than traction splints.


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## Willie Murphy (Oct 29, 2020)

Yeah, I can say without a doubt that if the Sam is something that is going to be utilized more in the coming years, which I think it is, then the training needs to be increased on it. I have only ever used improvised junctional tourniquets and that is why I am sort of skeptical of the Sam. Especially with the amount of space it takes up in my bag which is just a minor detail.  I am looking forward to using it and I know I need to train more on it soon. I do not want to be that guy fumbling around with this piece of equipment when it would have taken no time at all to use an improvised tourniquet. Does this tourniquet apply to all body types, seeing as it is geared towards tactical situations? Or would some hefty boi just have to go without?


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## Stretcher Jockey (Oct 29, 2020)

Willie Murphy said:


> Does this tourniquet apply to all body types, seeing as it is geared towards tactical situations? Or would some hefty boi just have to go without?


Just regarding your quote, Ive seen a CAT gen 7 put through the ends of the SAM (right next to the male and female ends of the belt buckle) and tightened to give some added girth. Granted this was in training and I've never seen that method in real life. That being said, Im a big fan of the SAM and (anecdotally) the few times I've applied to a non-compressable hemorrhage I've seen great success when accompanied with wound packing.


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