Written and maintained by CASRAI Editorial Board
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This page describes products and general use; it is not medical advice.
Short answer: tourniquets are usually sorted two ways. By mechanism, a peer-reviewed review of commercially available civilian tourniquets groups them as windlass, elastic, ratchet and pneumatic. By regulation, the FDA treats them as nonpneumatic (strap or tubing) or pneumatic (air-powered cuff). This guide connects the two views and does not rank any product.
Who uses these devices: first responders and trained bystanders (emergency limb bleeding), surgical teams (pneumatic cuffs), and clinic staff (straps used for venous access), plus the buyers and students who need to tell the categories apart.
What is a tourniquet?
Under 21 CFR 878.5900, a nonpneumatic tourniquet is “a device consisting of a strap or tubing intended to be wrapped around a patient’s limb and tightened to reduce circulation.” The same family of devices appears in emergency bleeding control, in surgery and in routine clinic work. Our guide What Is a Tourniquet? covers those contexts and the underlying principles; this page covers the types.
What is a CAT tourniquet?
CAT is the abbreviation for the Combat Application Tourniquet, a windlass-type device. In the 2020 review by Martinson and colleagues, the CAT is the comparator against which other commercially available tourniquets were tested, and the authors note that the Stop the Bleed program teaches it. That makes “CAT” a product name, not a separate regulatory category: it is a nonpneumatic strap-style device in the sense of the regulation above.
Tourniquet types by mechanism
Martinson J, Park H, Butler FK, Hammesfahr R, DuBose JJ, Scalea TM (Journal of Special Operations Medicine, 2020;20(2):116-122) searched PubMed from January 2012 to January 2020 for tourniquets tested against the CAT. They grouped the devices they found by mechanism:
| Mechanism group | Devices named in the review | Key difference |
|---|---|---|
| Windlass | CAT (comparator), SOFT-T, SOFT-T Wide, SAM-XT, MET, TMT | Windlass design, the same group as the CAT |
| Elastic | SWAT-T, IST, RATS | Elastic band design |
| Ratchet | RMT, TX2/TX3 | Ratchet design |
| Pneumatic | EMT, TPT | Air-inflated design |
The review is a literature review, not a product endorsement, and this page makes no claim about which device performs best.
Tourniquet types by FDA classification
The regulation text and the FDA device classification database (openFDA) sort tourniquets differently from the mechanism list above:
| Type | FDA product code and class | Regulation and definition |
|---|---|---|
| Nonpneumatic | GAX, class I | 21 CFR 878.5900: “a strap or tubing intended to be wrapped around a patient’s limb and tightened to reduce circulation.” Exempt from 510(k) subject to 878.9. |
| Gastro-urology tourniquet | EYR, class I | Listed under 878.5900 |
| Tourniquet kit | OJS, class I | Listed under 878.5900 |
| Pneumatic | KCY and QGX (general use), class I | 21 CFR 878.5910: “an air-powered device consisting of a pressure-regulating unit, connecting tubing, and an inflatable cuff,” inflated “to reduce or totally occlude circulation during surgery.” Exempt from 510(k) subject to 878.9. |
| Automatic rotating | DRP, class II | Listed under 870.5925 (cardiovascular devices) |
The two lists are separate systems: the mechanism groups come from a literature review, while the FDA entries come from regulation text. This page does not map individual brands onto FDA product codes. Product codes come from openFDA, which labels its data as unvalidated; the regulation text is the authoritative statement.
Which type for which setting
- Emergency limb bleeding: the devices in the review (windlass, elastic and ratchet groups) are strap-style products. The CAT is the one Stop the Bleed teaches.
- Surgery: the regulation describes pneumatic tourniquets as intended for use during surgery.
- Routine clinic use: strap or tubing bands for venous access fit the 878.5900 definition; see What Is a Tourniquet?.
Any choice among products should follow the manufacturer’s instructions for use and your organisation’s protocols.
How to apply or use a tourniquet
This page does not give step-by-step application instructions. Correct use depends on hands-on training. Stop the Bleed lists “apply a tourniquet” as one of the three bleeding-control actions it teaches, and its training page is the place to find a course. Always follow the specific manufacturer’s instructions for use for the device in your hands.
Common mistakes when comparing types
- Treating a brand as a category. “CAT” names one product in the windlass group, not a regulatory class.
- Mixing up mechanism and regulation. The mechanism groups in the review are not FDA types; the regulation distinguishes pneumatic from nonpneumatic.
- Assuming every pneumatic device is a surgical cuff. 21 CFR 878.5910 describes a surgical device with a pressure-regulating unit, tubing and cuff; the 2020 review also places two prehospital models (EMT, TPT) in its pneumatic group.
Related reading: items inside a first aid kit, what is a hemostat, and what is an elastic bandage. For catalogue categories, see emergency and trauma response supplies.
FAQ
What is a tourniquet?
A strap, tubing or inflatable cuff wrapped around a limb to reduce circulation (21 CFR 878.5900 and 878.5910).
What is a CAT tourniquet?
The Combat Application Tourniquet, a windlass-type device used as the comparator in the 2020 review and taught by Stop the Bleed.
How do you apply a CAT tourniquet?
Through hands-on training and the manufacturer’s instructions for use; this page does not give steps. Find a course at Stop the Bleed.
How do you use a tourniquet?
Use depends on the setting: emergency bleeding control, surgery with a pneumatic cuff, or clinic venous access. Follow training and the device’s instructions for use.
How do you use a CAT tourniquet?
See the answer on applying a CAT: training and the manufacturer’s instructions for use, not a web summary.
Sources
- 21 CFR 878.5900, Nonpneumatic tourniquet, law.cornell.edu (checked 2026-10-30).
- 21 CFR 878.5910, Pneumatic tourniquet, law.cornell.edu (checked 2026-10-30).
- openFDA device classification, tourniquet product codes, api.fda.gov (checked 2026-10-30).
- Martinson J et al. Tourniquets USA: review of commercially available alternative tourniquets for prehospital civilian use. J Spec Oper Med 2020;20(2):116-122. PMID 32573747, PubMed (checked 2026-10-30).
- Stop the Bleed training, stopthebleed.org (checked 2026-10-30).
