A limb tourniquet stops where the limb meets the body. The LST puts a pressure point there — and still works as a limb tourniquet below it.
At a glance
12 things to know about the LST
What it does at the groin and shoulder, what the FDA cleared, and how thin the evidence still is.
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01
One device, two jobs
On an arm or a leg the LST works like a standard windlass tourniquet. For the shoulder or upper thigh, a dedicated pressure pin presses on the artery that feeds the limb.6 The device is a handle, an inner strap, a buckle, a bridge, the pressure pin and a "cut here" section.3
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02
Why junctional bleeding needs its own tool
A limb tourniquet cannot get above a wound in the groin or the armpit. The TCCC Guidelines direct that when a bleeding site is amenable to a junctional tourniquet, one goes on immediately — with hemostatic packing and direct pressure if no junctional tourniquet is available, or while it is being readied.1
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03
FDA-cleared for the groin and the armpit
The FDA cleared the LST on 3 April 2026 under 510(k) K254060 as a Class II vascular clamp (21 CFR 870.4450, product code DXC) — the same classification as the SAM® Junctional Tourniquet, the JETT® and the AAJT-S. The cleared indications: battlefield and trauma situations, to control difficult bleeds in the inguinal area and in the axilla area, in adults.3,9
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04
What the FDA review rested on
TWM showed substantial equivalence to the SAM® Junctional Tourniquet with bench testing — usability, pressure retention and effectiveness during evacuation. The submission included no animal or clinical testing.3
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05
The volunteer study
In 32 healthy volunteers, the LST at the supraclavicular position stopped flow in 31 by all three measures — palpable pulse, pulse oximetry and Doppler. At the femoral position it did so in 30 of 31; one volunteer declined the groin. Five supraclavicular applications needed the rod for extra pressure.7
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06
Read that study with its limits
Its author is the LST's co-founder and chief medical officer. It had no comparison group, used volunteers who were not bleeding, did not measure the pressure applied, and did not test the device during transport — limits the paper states itself.7
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07
Groin: the pin over the femoral artery
Connect the pressure pin and place the LST over the pelvic bones with the pin over the femoral artery. Press on the device by hand until the bleeding stops, close the strap tightly, then turn the handle until the bleeding stops completely and secure it.5
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08
Shoulder: the pin above the collarbone
Connect the pin and seat it over the subclavian artery, perpendicular to the neck, pressing by hand until the bleeding stops. Pass the strap through the casualty's belt — or a second tourniquet — and through the buckle, close it tightly, and turn the handle for more pressure.5 This is the supraclavicular position the volunteer study tested.7
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09
Limb mode: 6 cm above the wound
On an arm or leg, TWM places the LST 6 cm (2.5 in.) above the injury, closes the strap firmly, turns the handle until the bleeding stops, and secures the handle and strap.5 That is the deliberate placement; under fire or with no visible source, the hasty high-and-tight placement over clothing still applies.1 TWM's label: never on a joint, never directly on the wound.5
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10
Hands stay on through evacuation
In both junctional modes, TWM's instructions call for manual pressure on the device throughout the evacuation.5 A 2019 systematic review found no evaluation of any junctional tourniquet during patient transport,8 so plan for someone to stay with it.
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11
Single use, stored sealed
The LST is nonsterile and single use — do not reuse it — and TWM instructs storing it in its original packaging.3,5 It is made for the professional user, and TWM states its instructions do not replace training.5
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12
Built by combat veterans
TWM – Tsadik Weiser Medical was founded by Yaakov Tsadik, an IDF commando veteran, and Dr. Giora Weiser, a senior pediatric emergency physician at Shaare Zedek Medical Center who serves as an IDF reserve physician.6 The LST carries Israeli Ministry of Health AMAR registration 37440001, Israeli patent 3034025 and U.S. patent 12,419,649.11
How to apply the LST
TWM's sequence for each mode, inside TCCC's order of operations.
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1Decide: limb or junctional. If a limb tourniquet can get above the wound, it is a limb bleed. If the source is in the groin or armpit, it is junctional — and the junctional tourniquet goes on as soon as it is ready.1
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2Pack and press while you set it up. Pack the wound with hemostatic gauze and hold direct pressure while the LST is readied.1
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3Groin. Pin connected, device over the pelvic bones with the pin over the femoral artery; press by hand until the bleeding stops; close the strap tightly; turn the handle until the bleeding stops completely, then secure it.5
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4Shoulder. Pin connected and seated over the subclavian artery, perpendicular to the neck; press by hand until the bleeding stops; route the strap through the casualty's belt or a second tourniquet and the buckle; close it tightly; turn the handle for more pressure.5
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5Keep your hands on it. Maintain manual pressure on the device throughout the evacuation.5
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6Limb mode. Deliberate: bare skin, 2–3 in. above the wound — TWM specifies 6 cm (2.5 in.) — moving above the joint if that spot lands on one. Hasty, under fire or with no visible source: high and tight over the clothing. Never across a joint. Turn the handle until the bleeding stops and the pulse below it is gone; secure the handle and strap.1,5
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7Mark the time. Use the time and date field on the device, and record it on the casualty card.1,5
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8Hand it off. Tell the receiving team a junctional device is on, where the pin sits and when it went on, and keep reassessing until they take over.
Where it fits
- Difficult bleeding in the groin (inguinal area) — an FDA-cleared indication3
- Difficult bleeding at the shoulder and armpit (axilla area) — an FDA-cleared indication3
- Life-threatening bleeding from an arm or a leg, in limb mode5
- Upper-thigh and shoulder wounds and high amputations too close to the body for a limb tourniquet6
- Neck wounds — pack them with care so the airway is not compressed; the lower neck above the collarbone can be packed
- The chest or abdomen
- Across a joint or directly on the wound5
- Children — the FDA clearance covers adults3
- Reuse — it is single use5
The evidence
Every study cited above, what it tested, and how strong the evidence is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Weiser, Chin J Traumatol 2026 | Human volunteer | LST at supraclavicular and femoral positions, 32 healthy volunteers; author is the device's co-founder | Complete occlusion 31/32 supraclavicular and 30/31 femoral by pulse, oximetry and Doppler; no comparison group |
| FDA 510(k) K254060, 2026 | Bench · regulatory | Usability, pressure retention and effectiveness-during-evacuation testing against the SAM® Junctional Tourniquet | Substantially equivalent; no animal or clinical testing in the submission |
| Smith et al., J Trauma Acute Care Surg 2019 | Systematic review · meta-analysis | Eight volunteer studies of the AAJT, JETT, SAM® Junctional Tourniquet and CRoC | Pooled effectiveness 83% JETT, 87% SAM-JT, 95% CRoC; AAJT groin 100% in two studies; transport not evaluated |
All junctional tourniquet data, the LST's included, come from healthy volunteers. The LST's single study is small, uncontrolled and written by the device's co-founder; field outcomes have not been reported.
How it compares
The junctional devices a buyer weighs against the LST — all cleared by the FDA as Class II vascular clamps.
| LST | SAM® Junctional Tourniquet | JETT® | AAJT-S | |
|---|---|---|---|---|
| How it compresses | Detachable pressure pin on a strap, tightened with a windlass handle | Hand-pumped pneumatic target compression device | Trapezoidal pressure pads on threaded T-handles | Inflatable wedge-shaped bladder on a belt |
| FDA 510(k) | K254060 (2026) | K123694, K131561 (2013) | K123194 (2013) | K221661 (2023) |
| FDA-cleared indications | Difficult bleeds in the inguinal and axilla areas | Inguinal and axilla bleeds; pelvic fracture immobilization | Difficult bleeds in the inguinal area | Bleeding in the pelvis, inguinal area and axilla; pelvic fracture stabilization |
| Limb tourniquet mode | Yes — windlass limb mode | — | — | — |
| Volunteer occlusion data | 31/32 supraclavicular, 30/31 femoral (one study, n = 32) | 87% pooled | 83% pooled | Groin 100% in two studies (AAJT) |
| evidence-based list | Never named | Named 2019; current list names no junctional device | Named 2019; current list names no junctional device | Not named |
Indications are each device's FDA-cleared wording.3,9 Pooled volunteer figures are from Smith et al.;8 the LST figure is its own study.7 The evidence-based list of 15 December 2021 names no junctional device; its 2019 versions named the CRoC, SAM-JT and JETT.2,10
Build the system
The other junctional devices, the limb tourniquet beside it, and the packing that holds the line while it goes on.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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