Abdominal Aortic and Junctional Tourniquet - Stabilized (AAJT - S) - Compression Works

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SKU: 30-0248

Type: Tourniquet

Vendor: Compression Works

Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)

Name: Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)
Brand: Compression Works
SKU: 30-0248
Price: 489.95 USD
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PRODUCT INFORMATION

Compression Works · Junctional & Abdominal Aortic Tourniquet

Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)

A wedge-shaped bladder on a ratcheting belt, inflated by hand pump until its gauge shows green. On the groin or the armpit it compresses the artery at that junction; over the navel it compresses the descending aorta, cutting blood flow to the pelvis and both legs. FDA-cleared to control bleeding in the pelvis, inguinal area and axilla, and for pelvic fracture stabilization.

FDA-cleared · K221661Groin · armpit · abdomen · pelvis1 h abdominal · 4 h junctionalBleed-off below 300 mmHgNSN 6515-01-695-4457

Abdominal placement shuts off arterial flow to the pelvis and both legs — which is why it runs on a one-hour clock and carries two contraindications you check before you inflate.

The short answer

What it is

A pneumatic junctional and abdominal aortic tourniquet: a wedge-shaped bladder, ladder strap and ratcheting buckle, hand pump and pressure gauge, with a bleed-off that keeps the bladder under 300 mmHg.

Use it for

Groin or armpit bleeding a limb tourniquet cannot control; pelvic and both-leg bleeding through the abdominal placement; pelvic fracture stabilization.

How it's used

Pack and press while it is readied. Connect red to red, set the bladder over the target, pull out all slack, ratchet tight, then inflate until the gauge shows green.

Who carries it

Combat and tactical medics, EMS systems with an AAJT-S protocol, flight and critical-care transport teams, and emergency departments — a device for trained, credentialed providers.

At a glance

Cleared for

Pelvic, groin and armpit bleeding; pelvic fracture

FDA

510(k) K221661

Mechanism

Pneumatic wedge bladder

Inflate to

Green on the gauge

Over-pressure

Bleed-off below 300 mmHg

Labeled time

4 h groin/armpit · 1 h abdomen

Weight

25 oz

Packaged size

9 × 8 × 2 in.

NSN

6515-01-695-4457

Manufacturer item

AAJT-S001 · NAR 30-0248

12 things to know about the AAJT-S

Where it goes, the clock and the contraindications, and what the volunteer, swine and case evidence shows.

01

Four uses from one belt

The FDA cleared the AAJT-S to control bleeding in the pelvis, inguinal area and axilla, and for pelvic fracture stabilization.⁴ Placement decides the job: over the navel for pelvic or both-leg bleeding, over the affected groin for one leg, over the armpit for the arm, and around the hips — uninflated — to stabilize the pelvis.^6,7
02

Abdominal placement compresses the aorta

Inflated over the lower abdomen, the wedge bladder pushes in on everything beneath it, including the descending aorta at or near the point where it divides into the iliac arteries.^4,6 That shuts off arterial flow to the pelvis and both legs at once — which is also why the abdominal placement runs on a shorter clock.
03

One hour on the abdomen, four at a junction

The AAJT-S is labeled for up to 1 hour in the abdominal position and up to 4 hours at the groin or armpit.^4,6 In survival swine, a 1-hour abdominal application was followed by full recovery of leg function within a week, while 2 hours produced lasting hind-leg paralysis; the investigators concluded abdominal use should not exceed 1 hour.¹⁵
04

Two contraindications — abdominal placement only

Do not place it on the abdomen with a known abdominal aortic aneurysm or in pregnancy. The instructions list no contraindications for groin or armpit placement.⁶
05

Tight before you inflate

Connect the ladder strap red to red, pull out all slack and finish with the ratcheting buckle. The tighter the belt before inflation, the more stable and effective the device, and the lower the bladder volume needed to compress the artery — faster and less painful.⁶ The ratchet replaced the original AAJT's windlass so the belt can be tightened with one hand.⁴
06

Inflate to green

Pump until the gauge shows green — the mark the instructions tie to 250 mmHg — and a bleed-off design keeps the bladder under 300 mmHg, including when altitude changes.⁶ Compression Works cites human studies in which flow stopped at 230 mmHg.⁶ For pelvic stabilization the bladder is not inflated.⁷
07

It hurts, and it affects breathing

In nine volunteers, the earlier abdominal tourniquet stopped femoral flow in seven at a median 180 mmHg, with a median discomfort score of 7 out of 10.¹¹ In spontaneously breathing swine with the earlier AAJT held on the abdomen for 2 hours, breathing became labored and stopped when the device was released, and three of six animals died after blood flow returned.¹⁴
08

Removal is a hospital decision

The instructions warn that removal may lead to resumed bleeding.⁶ Compression Works directs: never cut it off; deflate slowly while watching the casualty, then release the pull tab and the strap — and if bleeding returns, re-engage the strap and re-inflate.⁷ A 2026 case report describes cardiac arrest, compartment syndrome, rhabdomyolysis, organ infarcts, pulmonary emboli and stroke after removal in a trauma bay.²¹
09

What the S changed

The AAJT-S replaced the original AAJT's windlass with a ladder strap and ratcheting buckle, moved tightening to the front, added a D-handle for gloved hands, widened the belt, made the cover one continuous piece of HDPE plastic, and added the pelvic stabilization indication.⁴ Field testing of the original found durability problems: in Israeli Defense Forces medic testing, all three original AAJT units had broken by the fifth tester.¹⁸ The AAJT-S carries its own NSN, 6515-01-695-4457.^8,10
10

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 The same guidelines list XStat as best for deep, narrow-tract junctional wounds.¹
11

What volunteers and swine show

In 16 UK soldiers, the earlier abdominal tourniquet eliminated femoral flow in 15.¹² At the groin and armpit, the AAJT stopped flow in all 13 volunteers in its FDA submission.⁵ UK combat medical technicians applied the AAJT-S successfully in 27 of 34 attempts after one hour of training, in a median 75 seconds in daylight and 57 in low light.¹³ In swine, the AAJT and zone 3 REBOA — a balloon passed into the aorta — achieved similar bleeding control.^16,17
12

The evidence base is still thin

A 2025 systematic review found 14 studies — swine, healthy volunteers, one case report and one manikin study — no randomized trials and an overall low evidence base, with ischemia-reperfusion injury tied to how long the device stayed on.²⁰ Case series in traumatic cardiac arrest point both ways: no survivors to hospital discharge in a Sydney physician-led service,²² and return of circulation in all six casualties at a Ukrainian forward surgical site.²³ Compression Works notes that published cases may describe uses outside the FDA-cleared indications.⁷

How to apply the AAJT-S

Compression Works' five application steps, with the TCCC step before them and the checks after.

1

Control it by hand first. Pack the wound with hemostatic gauze and hold firm direct pressure while a teammate readies the AAJT-S.¹
2

Pick the site. Abdomen over the navel for pelvic or both-leg bleeding, the affected groin, or the armpit. Before an abdominal placement, rule out the contraindications: known abdominal aortic aneurysm or pregnancy.⁶
3

Connect red to red. Secure the belt around the waist, the hips or the shoulder and connect the ladder strap until the red marks meet.⁶
4

Position the bladder. Set it directly over the target: the navel, the affected groin or the armpit.⁶
5

Remove all slack. Pull the strap hard — the device must be very tight before inflation.⁶
6

Ratchet. Use the ratcheting buckle to complete the tightening.⁶
7

Inflate to green. Pump until the gauge shows green. For pelvic stabilization alone, do not inflate.^6,7
8

Record the time. Write down the inflation time — the clock is 1 hour on the abdomen and 4 hours at the groin or armpit.^1,6
9

Reassess and hand it off. Watch the bleeding, the breathing and the gauge through transport. Never cut it off; deflation and removal belong to the receiving clinicians.^6,7

Train on a trainer. An AAJT-S trainer is made for practice;²⁴ the live device is single use and stays with the casualty through the hand-off.^7,9 It ships ready to use in sealed packaging — while the seal is intact no field check is needed. If the package is damaged, inspect the belt, buckle, ladder strap and tubing, then inflate to green and wait 5 minutes; if the green drops out of view, do not use it.⁶

Where it fits

Use it for

Groin bleeding a limb tourniquet cannot control
Armpit bleeding
Pelvic and both-leg bleeding through the abdominal placement — up to 1 hour
Pelvic fracture stabilization, uninflated around the hips

Not for

Abdominal placement in pregnancy or with a known abdominal aortic aneurysm⁶
Abdominal use beyond 1 hour, or junctional use beyond 4 hours⁶
Limb bleeding a tourniquet can control — limb tourniquet first¹
Cutting it off to remove it — deflate and release instead⁷
Providers without device-specific training

The evidence

Every study cited above, what it tested, and how strong the evidence is.

Study	Evidence type	What was studied	What it found
*Lyon et al., J Trauma Acute Care Surg* 2012**	Human · volunteers	Earlier Abdominal Aortic Tourniquet over the lower abdomen, 9 volunteers	Femoral flow stopped in 7 of 9 at a median 180 mmHg; median discomfort 7/10, gone after removal
*Taylor et al., Mil Med* 2013**	Human · volunteers	Earlier Abdominal Aortic Tourniquet, 16 UK soldiers	Femoral flow eliminated in 15 of 16; all tolerated it
FDA 510(k) K133029 summary, 2013	Human · volunteers	AAJT at the groin and the armpit, 13 volunteers	Flow stopped at both sites in 13 of 13; mean bladder pressure 149 and 168 mmHg
*Smith TN et al., BMJ Mil Health* 2023**	Human · volunteers	AAJT-S applied by 17 UK combat medical technicians to one another, 34 applications	79% successful; median 75 s in daylight, 57 s in low light
*Chen et al., J Spec Oper Med* 2016**	Human · medic testing	CRoC, AAJT, JETT and SAM Junctional Tourniquet tested by 14 Israeli Defense Forces medics	All three original AAJT units broken by the fifth tester; top models did not differ significantly
*Kheirabadi et al., Shock* 2016**	Animal · swine	Earlier AAJT on the abdomen for 2 hours to control groin bleeding, 18 swine	Bleeding controlled; spontaneous breathers stopped breathing at release; 3 of 6 died after reflow
*Kheirabadi et al., J Surg Res* 2018**	Animal · survival swine	Abdominal AAJT for 1, 1.5 or 2 hours, followed up to 2 weeks	1 h: full recovery; 2 h: lasting paraplegia; abdominal use should not exceed 1 h
*Rall et al., J Surg Res* 2018**	Animal · randomized swine	AAJT vs zone 3 REBOA, femoral artery bleeding, 10 swine	Both 100% hemostasis; AAJT had higher blood pressure and lactate
*Schechtman et al., J Trauma Acute Care Surg* 2020**	Animal · swine	AAJT vs zone 3 REBOA for 60 minutes, 20 swine in severe shock	Similar bleeding control; transiently lower blood pressure after AAJT deflation
*Smith S et al., J Trauma Acute Care Surg* 2019**	Expert review · meta-analysis	Eight healthy-volunteer studies of four junctional devices	Abdominal AAJT 52% average effectiveness; groin placement 100% in 2 studies
*Webster et al., BMJ Mil Health* 2025**	Expert review · systematic review	Evidence for the AAJT-S in combat care, 14 studies	No randomized trials; overall low evidence; ischemia-reperfusion injury dependent on duration
*Balian et al., Resuscitation* 2020**	Human · case series	AAJT in prehospital traumatic cardiac arrest, physician-led service, Sydney	Physiological changes and some return of circulation; no survivors to hospital discharge
*Androshchuk & Verba, J Spec Oper Med* 2025**	Human · case series	AAJT-S in 6 casualties in traumatic cardiac arrest, forward surgical site, Ukraine	All 6 resuscitated; 4 survived to discharge
*Gerstner et al., Prehosp Emerg Care* 2026**	Human · case report	Young adult with pelvic and leg gunshot wounds arriving with an AAJT-S in place	Cardiac arrest after removal, then multi-organ complications; authors urge caution

Strongest to weakest: human studies, then animal studies. The human data are healthy volunteers and small case series, several on the earlier AAT and AAJT models; no trial has measured survival. The swine studies show both the hemostatic effect and the time-dependent cost of compressing the aorta.

How it compares

The four FDA-cleared junctional devices a buyer weighs, side by side.

	AAJT-S	SAM Junctional Tourniquet	JETT	CRoC
Mechanism	Hand-pumped wedge bladder on a ratcheting belt	Hand-pumped target compression device on a force-limiting belt	Two screw-down pressure pads on a belt	Aluminum clamp with a screw-down pressure disc
FDA-cleared for	Bleeding in the pelvis, inguinal area and axilla; pelvic fracture stabilization	Inguinal and axillary bleeding; pelvic fracture immobilization	Inguinal bleeding	Inguinal and axillary bleeding; last resort for carotid bleeding
Both groins from one device	Abdominal placement stops flow to both legs	Yes — the JT400-EN kit carries two compression devices	Yes — two pads	No — one clamp per side
Labeled maximum	4 h groin or armpit · 1 h abdomen	4 h	4 h	4 h
Weight	25 oz	24 oz (JT400-EN)	1 lb 8 oz	1.25 lb
Volunteer effectiveness (meta-analysis)	Earlier AAJT: 52% abdominal; groin 100% in 2 studies	87%	83%	95%
Mean application time (meta-analysis)	Earlier AAJT, abdominal: 92 s and 171 s	101 s	130 s	101 s
Named on the 2019 evidence-based list	No	Yes	Yes	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;^4,6,25,26,27 weights from published specifications;^8,25,26,27 effectiveness and application times are averages from healthy-volunteer studies, which tested the earlier AAJT, not the AAJT-S.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.

QuikClot® Combat Gauze®

Pack the wound while the AAJT-S is readied

XSTAT® Wound Dressing

Expanding sponges for deep, narrow-tract junctional wounds

SAM® Junctional Tourniquet

Pneumatic groin and armpit device

JETT®

Mechanical two-pad groin device

CRoC Combat Ready Clamp

Single-site junctional clamp

SAM® Pelvic Sling

Dedicated pelvic binder

TrueClot Inguinal Packing Trainer

Practice groin packing on a wearable trainer

C-A-T® Gen 7

Limb tourniquet for bleeding below the junction

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Questions buyers ask

▾Is the AAJT-S evidence-based standard?

No. The 2019 Evidence-Based Standard Devices list named three junctional devices — the CRoC, SAM-JT and JETT — and not the AAJT.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 AAJT-S, cleared for groin and armpit bleeding, meets that criterion.⁴

▾When is the abdominal placement used?

For bleeding in the pelvis or in both legs — the indications the instructions pair with placement over the navel.⁶ It compresses the aorta, so it is limited to 1 hour and is contraindicated in pregnancy or with a known abdominal aortic aneurysm.^4,6

▾Can it be used on a pregnant casualty?

Not on the abdomen — pregnancy is a contraindication for abdominal placement. The instructions list no contraindications for groin or armpit placement.⁶

▾How long can it stay on?

Up to 1 hour on the abdomen and up to 4 hours at the groin or armpit.^4,6 Record the inflation time when it goes on.¹

▾How much pressure does it use?

Inflate until the gauge shows green, the 250 mmHg mark; a bleed-off keeps the bladder under 300 mmHg even with altitude change. A tight belt before inflation means less bladder volume and less pain.⁶

▾Should I pack the wound first?

Yes, while the AAJT-S is being readied — the TCCC Guidelines call for hemostatic dressings with direct pressure until the junctional tourniquet is ready, then immediate application.¹

▾How is it removed?

By the receiving clinicians, never by cutting. The bladder is deflated slowly while the casualty is monitored, then the pull tab and strap are released; removal may bring the bleeding back, and the strap can be re-engaged and the bladder re-inflated.^6,7

▾Does it work as a pelvic binder?

Yes — pelvic fracture stabilization is a cleared indication. Place it around the hips, centered over the pelvis, tighten it, and do not inflate the bladder.^4,6,7

▾Has it been used in the armpit on real casualties?

Yes. The first reported human use of a junctional tourniquet for armpit bleeding was the AAJT's predecessor, off-label in 2013, reported by the device's inventor, who also reported a groin gunshot case.²⁸ Armpit bleeding is now a cleared indication.⁴

▾How do I store and check it?

Leave it in its sealed package — while the seal is intact, no field check is needed. If the package is damaged, inspect the belt (do not use it with a cut longer than 2 mm), the buckle, the ladder strap and the tubing, then inflate to green for 5 minutes; if the green drops out of view, do not use it.⁶

▾Is it reusable? Is there a trainer?

The AAJT-S is single use and stays with the casualty through the hand-off.^7,9 An AAJT-S trainer is made for practice.²⁴

Package & specifications

▾In the package — one device, sealed

1× AAJT-S belt with wedge-shaped bladder, ladder strap, ratcheting buckle and D-handle — Compression Works model AAJT-S001
Hand pump and tubing with integrated pressure gauge, bleed-off and deflation valve
Instructions for use
Sealed, ready-to-use packaging. Non-sterile, single use.

▾Full specifications

Specification	Detail
Manufacturer	Compression Works, Inc. — Birmingham, Alabama
Product	Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)
Manufacturer model	AAJT-S001
Distributor item	North American Rescue 30-0248
NSN	6515-01-695-4457
GTIN (UDI-DI)	00860002227504
FDA	510(k) K221661, cleared 3 March 2023 — Class II, product code DXC (vascular clamp). Predecessors: AAJT K133029 (2013); Abdominal Aortic Tourniquet K112384 (2011)
Cleared indications	To control bleeding in the pelvis, inguinal area, axilla and for pelvic fracture stabilization
Labeled time	Up to 1 hour abdominal; up to 4 hours junctional (groin or axilla)
Contraindications	Abdominal placement: known abdominal aortic aneurysm; pregnancy. None listed for groin or armpit placement
Mechanism	Wedge-shaped pneumatic bladder; ladder strap and ratcheting buckle; D-handle; hand pump; pressure gauge
Inflation	To the green indicator (250 mmHg check point); bleed-off keeps pressure under 300 mmHg
Weight	25 oz
Dimensions	Packaged 9 × 8 × 2 in.; stored 7.5 × 6.5 × 2 in.
Packaging	Sealed, ready to use
Sterility / use	Non-sterile, single use; stays with the casualty
Origin	Manufactured in USA
Clinical evaluation	Not named on the 2019 list; the current Evidence-Based Standard Devices list (15 Dec 2021) names no specific junctional device

▾References — 28 sources

Committee on Tactical Combat Casualty Care. Tactical Combat Casualty Care (TCCC) Guidelines, 1 May 2026.
Committee on Tactical Combat Casualty Care. Evidence-Based Standard Devices & Adjuncts, 15 December 2021.
Committee on Tactical Combat Casualty Care. Evidence-Based Standard Devices & Adjuncts, 1 August 2019 (Junctional Tourniquets & Devices: CRoC, SAM-JT, JETT).
U.S. Food and Drug Administration. 510(k) K221661, Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S), Compression Works, cleared 3 March 2023 — indications for use and 510(k) summary.
U.S. Food and Drug Administration. 510(k) K133029, Abdominal Aortic and Junctional Tourniquet (AAJT), cleared 6 December 2013, and K112384, Abdominal Aortic Tourniquet, cleared 18 October 2011 — 510(k) summaries.
Compression Works. Abdominal Aortic & Junctional Tourniquet (Stabilized) AAJT-S Instructions for Use, US rev 002 (28 February 2022).
Compression Works. AAJT-S product, training and protocol pages, and AAJT-S Application & Removal Guide (2026).
North American Rescue. AAJT-S product information sheet, item 30-0248 (REV101625).
National Library of Medicine. AccessGUDID device record 00860002227504, Abdominal Aortic & Junctional Tourniquet (Stabilized) – AAJT-S, model AAJT-S001.
Defense Logistics Agency. Federal Logistics Information System record, NSN 6515-01-695-4457 (abdominal aortic and junctional tourniquet-stabilized, AAJT-S001).
Lyon M, Shiver SA, Greenfield EM, et al. Use of a novel abdominal aortic tourniquet to reduce or eliminate flow in the common femoral artery in human subjects. J Trauma Acute Care Surg. 2012;73(2 Suppl 1):S103–S105.
Taylor DM, Coleman M, Parker PJ. The evaluation of an abdominal aortic tourniquet for the control of pelvic and lower limb hemorrhage. Mil Med. 2013;178(11):1196–1201.
Smith TN, Beaven A, Handford C, Sellon E, Parker PJ. Abdominal Aortic Junctional Tourniquet – Stabilized (AAJTS) can be applied both successfully and rapidly by Combat Medical Technicians (CMTs). BMJ Mil Health. 2023;169(6):493–498.
Kheirabadi BS, Terrazas IB, Miranda N, et al. Physiological consequences of Abdominal Aortic and Junctional Tourniquet (AAJT) application to control hemorrhage in a swine model. Shock. 2016;46(3 Suppl 1):160–166.
Kheirabadi BS, Terrazas IB, Miranda N, et al. Long-term consequences of abdominal aortic and junctional tourniquet for hemorrhage control. J Surg Res. 2018;231:99–108.
Rall JM, Redman TT, Ross EM, Morrison JJ, Maddry JK. Comparison of zone 3 Resuscitative Endovascular Balloon Occlusion of the Aorta and the Abdominal Aortic and Junctional Tourniquet in a model of junctional hemorrhage in swine. J Surg Res. 2018;226:31–39.
Schechtman DW, Kauvar DS, De Guzman R, et al. Abdominal aortic and junctional tourniquet versus zone III resuscitative endovascular balloon occlusion of the aorta in a swine junctional hemorrhage model. J Trauma Acute Care Surg. 2020;88(2):292–297.
Chen J, Benov A, Nadler R, et al. Testing of junctional tourniquets by medics of the Israeli Defense Force in control of simulated groin hemorrhage. J Spec Oper Med. 2016;16(1):36–42.
Smith S, White J, Wanis KN, et al. The effectiveness of junctional tourniquets: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2019;86(3):532–539.
Webster S, Ritson JE, Barnard EBG. Abdominal aortic junctional tourniquet (AAJT-S): a systematic review of utility in military practice. BMJ Mil Health. 2025;171(3):262–268.
Gerstner G, Rizzo J, Kieffer C, Lowe J. Between hemorrhage and harm: complications of the Abdominal Aortic and Junctional Tourniquet-Stabilized. Prehosp Emerg Care. 2026 (published online 10 September 2026).
Balian F, Garner AA, Weatherall A, Lee A. First experience with the abdominal aortic and junctional tourniquet in prehospital traumatic cardiac arrest. Resuscitation. 2020;156:210–214.
Androshchuk D, Verba A. Successful management of battlefield traumatic cardiac arrest using the Abdominal Aortic and Junctional Tourniquet (AAJT): a case series. J Spec Oper Med. 2025;25(1):65–69.
Bound Tree Medical. Abdominal Aortic and Junctional Tourniquet (AAJT-S), Trainer — Compression Works, item 97-1220-00248.
U.S. Food and Drug Administration. 510(k) K123694 (7 March 2013) and K131561 (24 July 2013), SAM Junctional Tourniquet; SAM Medical, SJT product specification sheet SJT-SS-05 and Instructions for Use JT-IS-EN-05.
U.S. Food and Drug Administration. 510(k) K123194, Junctional Emergency Treatment Tool, North American Rescue, cleared 3 January 2013; North American Rescue, JETT Instructions for Use ZZ-0450 and product information sheet, item 30-0088.
U.S. Food and Drug Administration. 510(k) K130482 (29 April 2013) and K141685 (26 January 2015), Combat Ready Clamp (CRoC), Combat Medical Systems — indications, 4-hour use, 1.25 lb with disc.
Croushorn J, McLester J, Thomas G, McCord SR. Abdominal aortic tourniquet controls junctional hemorrhage from a gunshot wound of the axilla. J Spec Oper Med. 2013;13(3):1–4; Croushorn J. Abdominal aortic and junctional tourniquet controls hemorrhage from a gunshot wound of the left groin. J Spec Oper Med. 2014;14(2):6–8.

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Built around MARCH. Every kit we sell maps to the MARCH protocol — Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia. Learn the sequence in our complete MARCH guide.

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FREQUENTLY ASKED QUESTIONS

What makes the AAJT-S different from the JETT and SAM Junctional Tourniquet?

The AAJT-S is the only FDA-cleared hemorrhage control device indicated for external abdominal aortic compression — a capability the JETT and SAM Junctional Tourniquet do not have. All three devices address inguinal and axillary junctional hemorrhage, but only the AAJT-S can be placed at the aortic bifurcation (lower abdomen) to achieve Zone 3 REBOA-equivalent compression without vascular access. This makes it the only non-invasive tool capable of addressing Non-Compressible Torso Hemorrhage (NCTH). It is also the only device cleared for all four indications simultaneously: abdominal, inguinal, axillary, and pelvic fracture stabilization.

Is the AAJT-S CoTCCC-recommended?

The AAJT-S is not currently on the CoTCCC junctional tourniquet recommendation list as of 2025. CoTCCC formally recommends the JETT and SAM Junctional Tourniquet as the primary junctional devices. The AAJT-S was considered in the original 2013 CoTCCC junctional tourniquet review but was designated as a device of last resort for abdominal placement due to its 1-hour abdominal application limit and relative contraindication in penetrating abdominal trauma — injuries common in conjunction with junctional hemorrhage. For inguinal and axillary use, it has a broader indication set than any single competing device.

How is the pressure indicator used when applying the AAJT-S?

The AAJT-S includes a built-in pressure gauge with a green zone indicator calibrated to approximately 250 mmHg. The operator inflates the hand pump bulb until the gauge indicator reaches green, confirming sufficient arterial compression pressure. A built-in 300 mmHg pressure relief valve automatically prevents over-inflation — the bladder will not exceed safe pressure regardless of how many additional pump strokes are applied. This 'inflate to green' protocol eliminates the operator pressure judgment variability that affects manual compression and non-gauged devices.

Can the AAJT-S be used for Zone 3 REBOA?

Yes, but as a non-invasive external adjunct, not a replacement for interventional REBOA. A 2024 study in the Journal of Special Operations Medicine demonstrated that AAJT-S abdominal placement provides clinically significant Zone 3 aortic and vena cava compression, reducing blood flow distal to the device and improving proximal perfusion to the thorax and brain. Unlike invasive REBOA — which requires femoral arterial access and a trained operator — the AAJT-S can be applied by any trained first responder in under 2 minutes with minimal equipment. It is most valuable as a bridge to surgical or interventional care when REBOA is unavailable.

How long can the AAJT-S remain in place, and what are the risks of prolonged use?

For abdominal (aortic) placement, the manufacturer recommends a maximum application time of 1 hour due to the risk of ischemia-reperfusion injury to abdominal organs and spinal cord distal to the device. Animal studies at 90 minutes showed developing paraplegia and colonic necrosis; the 60-minute group had no lasting side effects. For inguinal and axillary placements, up to 4 hours is recommended, consistent with guidance for other junctional tourniquets. All placements require continuous monitoring for hemorrhage control, patient tolerance, and hemodynamic response. Application time must be documented immediately.

Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)

At a glance

12 things to know about the AAJT-S

Four uses from one belt

Abdominal placement compresses the aorta

One hour on the abdomen, four at a junction

Two contraindications — abdominal placement only

Tight before you inflate

Inflate to green

It hurts, and it affects breathing

Removal is a hospital decision

What the S changed

Packing and pressure come first while it's readied

What volunteers and swine show

The evidence base is still thin

How to apply the AAJT-S

Where it fits

The evidence

How it compares

Build the system

Questions buyers ask