LST - Life Saving Extremity and Junctional Tourniquet: "The Israeli Tourniquet"

Key Specifications

Junctional vs. Extremity Hemorrhage: Why a Separate Device?

Standard limb tourniquets — including the CoTCCC-recommended C-A-T Gen 7 and SAM XT — work by encircling a limb and applying uniform circumferential pressure to compress the underlying artery against bone. This mechanism is highly effective on arms and legs below the torso junction but is anatomically impossible in the groin (inguinal region) and armpit (axillary region), where the limb meets the torso and no proximal surface area for a circumferential cuff exists.

Junctional hemorrhage — defined as compressible bleeding at the trunk–appendage interface (groin, pelvis, shoulder, or neck) — accounts for approximately 19% of potentially survivable battlefield deaths, according to research published in the Journal of Special Operations Medicine (Kotwal et al., 2013). Be precise about what that figure means: it is a share of potentially survivable deaths, not of all deaths, and junctional hemorrhage is not the single largest category — noncompressible truncal hemorrhage remains the larger problem and is not addressable with any external device. What the number does establish is that a meaningful fraction of preventable deaths occur in an anatomical zone a limb tourniquet cannot reach. Devices that deliver focused, targeted pressure directly over the proximal artery exist to close that specific gap.

The LST addresses this gap with a single, compact device. For limb injuries, it applies like a conventional windlass tourniquet. For junctional wounds, the built-in pressure pin is positioned directly over the femoral pulse below the inguinal ligament or over the axillary artery, and the strap is tightened to create focal arterial compression — stopping blood flow at the anatomical transition zone where standard tourniquets fail.

Product Overview

The LST was developed by Yaakov Tsadik and Dr. Giora Weiser at T-W Medical Ltd. following Tsadik's field experience with the gap in junctional hemorrhage control. The design concept — a single device that transitions seamlessly between limb and junctional modes — required two years of prototyping and clinical iteration before arriving at the current solution: a lightweight, windlass-based tourniquet with a precisely shaped pressure element that, when positioned over the target artery and tightened, achieves focal occlusion with less total strap tension than broad circumferential methods.

The manufacturer cites a 2025 feasibility and effectiveness study conducted at Shaare Zedek Medical Center in Jerusalem evaluating the LST at femoral and supraclavicular targets, reporting support for the device's junctional effectiveness in trained users. Read that with the appropriate caution: we have not been able to independently verify the journal, study design, sample size, or effect size, and a manufacturer-cited result is not the same tier of evidence as an independently reproduced clinical trial. Treat it as a manufacturer claim pending verification, not as established outcome data. The long strap (155 cm / ~61 inches) is explicitly designed to accommodate individuals with significant tactical midsection girth under body armor or kit, a practical limitation of some competing junctional devices. T-W Medical holds international patents covering the pressure element geometry and the dual-mode deployment system.

The LST is positioned as a complement to — not a replacement for — established CoTCCC-recommended limb tourniquets. Clinicians and tactical medics integrating the LST into kit configurations typically stage it alongside a CAT Gen 7 or SAM XT for limb injuries while reserving the LST for junctional scenarios, or rely on its dual-mode capability as a single-item solution in minimalist loadouts where pack weight and space are at a premium.

Application Guide

Limb Mode (Arms and Legs):

1. Place the LST above the injury, 2–3 inches proximal to the wound site, directly on skin where possible. If 2–3 inches above the wound lands on a joint, move proximal past the joint — never place a tourniquet across a joint.
2. Thread the limb through the loop; pull the strap firmly to remove all slack.
3. Rotate the windlass rod until bleeding stops and no distal pulse is detectable.
4. Secure the windlass and strap; note application time immediately.

Junctional Mode (Groin / Axilla):

1. Expose the injury and locate the anatomical landmark: femoral pulse just below the inguinal ligament, or infraclavicular fossa for axillary control.
2. Position the pressure pin directly over the target artery at the identified landmark.
3. Pass the strap around the pelvis or torso and tighten firmly using the buckle system; apply the windlass for additional pressure if required.
4. Confirm hemorrhage control by assessing the wound and checking for distal pulse cessation.
5. Secure the device and document application time; reassess after every patient movement or transfer.

For dedicated, purpose-built junctional tourniquets, see the JETT Junctional Emergency Treatment Tool and the SAM Junctional Tourniquet — both FDA-cleared, and neither carrying a CoTCCC product recommendation, because none exists for this device class. For a complete selection of tourniquets and pouches, or to build a full massive hemorrhage control kit, browse MED-TAC's full collections.

All products sourced from the actual brand manufacturer or authorized master distributors. Device designations stated as of the current TCCC Guidelines edition. Ships from MED-TAC International, South Florida, US of A — clinician-founded, veteran-led, SDVOSB-certified.