One belt, three jobs — groin, armpit and pelvis — and the buckle tells you by sound and feel when the belt force is right to inflate.
At a glance
12 things to know about the SAM Junctional Tourniquet
What it is cleared for, how the buckle and compression device work, and what the studies found.
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01
One belt, three cleared jobs
The SJT is FDA-cleared for battlefield and trauma situations to control difficult bleeds in the inguinal area and in the axilla area, and to immobilize a pelvic fracture.4,5 The groin and pelvic indications were cleared in March 2013 and the armpit in July 2013.4,5 Junctional sites accounted for 19.2% of the potentially survivable hemorrhage deaths among U.S. combat fatalities from 2001 to 2011.20
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02
The buckle sets the belt force for you
Pull the brown handles apart and the AUTOSTOP buckle clicks once the belt reaches its optimal force — 150 N of circumferential pressure, the point where its prongs extend through the precision strap.6,7 The clearance describes this as feedback that a minimum belt force has been reached, after which the compression device is inflated.4
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03
The Target Compression Device does the arterial work
The TCD inflates with the removable hand pump or any luer-lock syringe and rises up to 3.2 in. over its target.7 It can press directly on an artery or over a hemostatic dressing; when it sits directly over a wound, SAM directs sterile gauze or a hemostatic dressing underneath it.5,6 In perfused cadavers it occluded the artery above the groin at a mean 107 mmHg, against 139 mmHg for manual pressure, and the armpit artery at 739 mmHg against 1,237.10
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04
Two compression devices cover both groins
The JT400-EN kit ships two TCDs, so both groins can be compressed from one belt. The JT401-EN kit carries a single TCD and no extender or auxiliary strap.6,7
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05
The armpit takes the extender and the auxiliary strap
For axillary bleeding the belt goes under the arms as high as possible, with its D-ring on the injured side in line with the side of the neck. The extender fits over the TCD for the anatomy below the collarbone, and the auxiliary strap runs from the D-ring to the back of the belt near the midline before the TCD is pumped up.6,7
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06
Pelvic mode: no TCD, belt at the hips
To immobilize a pelvic fracture, slide the belt under the casualty without the TCD, at the level of the trochanters — the bony points of the hips — and buckle it until it clicks.6 The clearance used SAM's own Pelvic Sling as a predicate device.4 The TCCC Guidelines call for a pelvic binder whenever a pelvic fracture is suspected after severe blunt or blast injury.1
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07
Altitude changes the inflation
SAM warns that changes in altitude may call for additional pumping, and that when altitude change is a concern the TCD can be filled by syringe with water, saline or another non-compressible fluid instead of air.6 Flight and mountain teams should train that option.
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08
Labeled for up to four hours
SAM labels the SJT to control junctional bleeding for up to 4 hours where standard tourniquets cannot be used.6 In prolonged use as a pelvic sling, check the skin underneath for pressure injury.6
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09
Packing and pressure come first while it's readied
The TCCC Guidelines direct a junctional tourniquet immediately when the bleeding site is amenable to one, with no delay once it is ready — and hemostatic dressings with direct pressure if a junctional tourniquet is not available or while it is being readied.1 With the SJT the packing does not have to come out: the TCD goes on over it.5,6
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10
What the volunteer studies found
In human volunteers, the CRoC, SJT and JETT were the most effective of four junctional models, and the CRoC and SJT were the fastest.12 In 84 healthy volunteers in battle dress, tested after exercise, the SJT and CRoC each stopped popliteal flow in almost 90% and the SJT went on faster.14 On a bleeding groin manikin, the CRoC and SJT lost the least simulated blood.16 A meta-analysis put average SJT effectiveness at 87%, with a mean application time of 101 seconds.19
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11
Transport and training are the weak points
When 49 corpsmen applied three devices to one another, the SJT held better than the JETT after a short transport — but no device performed well, at 24–48% effectiveness.13 In a Fort Hood trial only 28% of combat lifesavers and 40% of combat medics placed both the SJT and the JETT successfully, though both groups preferred the SJT;15 chemical-protective (MOPP) gear slowed application from 167 to 223 seconds.17
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12
Battlefield use and Clinical evaluation
The first known prehospital use of the SJT was on a battlefield casualty with groin bleeding in Afghanistan.11 The 2019 Evidence-Based Standard Devices list named it as the SAM-JT (NSN 6515-01-618-74759) with the CRoC and the JETT;3 the current list, dated 15 December 2021, names no specific junctional product and leaves the choice to any FDA-cleared device indicated for junctional hemorrhage control.2 The SJT meets that criterion; it is not evidence-based standard by name.
How to apply the SJT to the groin
SAM Medical's inguinal instructions in order, with the TCCC step that comes before them.
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1Control it by hand first. Pack the wound with hemostatic gauze and hold firm direct pressure while a teammate readies the SJT.1
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2Clear the site. Remove objects from the casualty's pockets and clothing where the belt and TCD will sit.6
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3Slide the belt under and place the TCD. Pass the belt under the casualty and set the TCD over the area to be compressed — over sterile gauze or a hemostatic dressing if it sits directly on the wound. For both groins, use the second TCD.6
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4Buckle it. Hold the TCD in place and connect the belt with the buckle.6
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5Pull until it clicks. Pull the brown handles away from each other until the buckle secures with an audible click, then press the excess belt down onto the hook-and-loop. A second click may follow as the belt settles.6
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6Pump the TCD. Inflate with the hand pump until the bleeding stops.6
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7Record the time. Write the application time on the casualty card, as for any tourniquet.1
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8Monitor and hand it off. Recheck bleeding control through transport and adjust the device as needed; it is labeled for up to 4 hours.6 Removal — unbuckling the belt — is for the receiving clinicians.
Where it fits
- Groin bleeding a limb tourniquet cannot control — one side or both
- Armpit bleeding, with the extender and auxiliary strap
- Immobilizing a suspected pelvic fracture, belt only
- Holding pressure over a packed junctional wound so your hands are free
- Limb bleeding a tourniquet can control — limb tourniquet first1
- Use beyond 4 hours6
- Pelvic-binder use with the TCD in place — the belt goes on without it6
- Reuse after a casualty or after training — single use6
The evidence
Every study cited above, what it tested, and how strong the evidence is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Johnson et al., J Spec Oper Med 2014 | Cadaver · perfused model | SJT on perfused cadavers, simulated groin and armpit bleeding | Mean 107 mmHg occluded the distal external iliac artery (manual pressure 139); 739 mmHg the axillary artery (manual 1,237); no tissue damage |
| Kragh et al., Prehosp Emerg Care 2015 | Human · volunteers | CRoC, AAJT, JETT and SJT on 10 volunteers; distal pulse by Doppler | CRoC, SJT and JETT most effective, no significant difference; CRoC and SJT fastest |
| Meusnier et al., J Spec Oper Med 2016 | Human · randomized volunteers | CRoC vs SJT, 84 healthy volunteers in battle dress after exercise | Almost 90% effective with either device; SJT faster and preferred |
| Gaspary et al., Prehosp Emerg Care 2019 | Human · randomized volunteers | CRoC, JETT and SJT applied by 49 corpsmen to fellow participants, then a short transport | SJT and JETT faster than CRoC; after transport SJT held better than JETT, all 24–48%; SJT ranked first by users |
| Flecha et al., Mil Med Res 2018 | Manikin · randomized crossover | SJT and JETT applied by 133 combat lifesavers and 94 combat medics | 28% of combat lifesavers and 40% of medics placed both successfully; both groups preferred the SJT |
| Kragh et al., Prehosp Disaster Med 2016 | Manikin | CRoC, JETT and SJT, 30 users, 270 tests on a bleeding groin manikin | All controlled the bleeding; CRoC and SJT had the least blood loss |
| Wagner et al., Mil Med 2020 | Manikin · randomized | SJT applied by 49 combat medics with and without MOPP chemical-protective gear | 223 s vs 167 s with MOPP gear; success 64% vs 81% (not significant) |
| Zhao et al., Chin J Traumatol 2023 | Animal · randomized swine | SJT on axillary bleeding at 210 mmHg for 2 hours, 18 swine | Bleeding controlled; spontaneously breathing animals had respiratory arrest after 2 hours; ventilation lessened the effect |
| Smith et al., J Trauma Acute Care Surg 2019 | Expert review · meta-analysis | Eight healthy-volunteer studies of four junctional devices | Average effectiveness SJT 87%, JETT 83%, CRoC 95%; mean application 101 s for SJT |
| Klotz et al., J Spec Oper Med 2014 | Human · case report | Battlefield casualty with groin bleeding, Afghanistan | First known prehospital use of the SJT |
| Eastridge et al., J Trauma Acute Care Surg 2012 | Human · mortality review | 4,596 U.S. battlefield deaths, 2001–2011 | Junctional sites accounted for 19.2% of potentially survivable hemorrhage deaths |
No trial has measured survival with any junctional tourniquet. The device evidence is cadaver, swine, manikin and healthy-volunteer work plus case reports — read it as mechanism, speed and usability, not as proof of outcome.
How it compares
The four FDA-cleared junctional devices a buyer weighs, side by side.
| SAM Junctional Tourniquet | JETT | AAJT-S | CRoC | |
|---|---|---|---|---|
| Mechanism | Hand-pumped target compression device on a force-limiting belt | Two screw-down pressure pads on a belt | Hand-pumped wedge bladder on a ratcheting belt | Aluminum clamp with a screw-down pressure disc |
| FDA-cleared for | Inguinal and axillary bleeding; pelvic fracture immobilization | Inguinal bleeding | Bleeding in the pelvis, inguinal area and axilla; pelvic fracture stabilization | Inguinal and axillary bleeding; last resort for carotid bleeding |
| Both groins from one device | Yes — the JT400-EN kit carries two compression devices | Yes — two pads | Abdominal placement stops flow to both legs | No — one clamp per side |
| Labeled maximum | 4 h | 4 h | 4 h groin or armpit · 1 h abdomen | 4 h |
| Weight | 24 oz (JT400-EN) | 1 lb 8 oz | 25 oz | 1.25 lb |
| Volunteer effectiveness (meta-analysis) | 87% | 83% | Earlier AAJT: 52% abdominal; groin 100% in 2 studies | 95% |
| Mean application time (meta-analysis) | 101 s | 130 s | Earlier AAJT, abdominal: 92 s and 171 s | 101 s |
| Named on the 2019 evidence-based list | Yes | Yes | No | Yes |
| evidence-based standard today | No — the current list names no junctional device | No — the current list names no junctional device | No — the current list names no junctional device | No — the current list names no junctional device |
Indications and labeled times come from each device's FDA 510(k) record and instructions;4,5,6,21,22,23 weights from the manufacturers' published specifications;7,21,22,23 effectiveness and application times are averages from healthy-volunteer studies.19 The current evidence-based list names no junctional product at all;2 absence from it does not by itself mean a device was tested and failed.
Build the system
The packing that goes in first, the other junctional options, a dedicated pelvic binder and the training aid.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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