Pack the hole, hold the pressure, then let the ETD hold it for you — your hands belong to the next problem.
At a glance
12 things to know about the ETD
How it is built, what each part is for, how tight is right, and where it sits in a trauma kit.
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01
Designed from battlefield after-action reviews
North American Rescue engineered the ETD using data from more than 63 after-action reviews of real-world battle-dressing applications. The result is four parts: a resilient elastic wrap, a sterile non-adherent pad, a durable securing device and Quick-Grip Roll Control.3
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02
No pressure bars, no hooks — on purpose
NAR left out pressure bars and hooks to reduce the fine motor skill the job takes, so the application is easy to remember under combat or survival stress.3,4 The Israeli-type Emergency Bandage takes the other route — a pressure applicator and a closure bar16 — and in pressure testing on the arm its bar raised pressure directly under it without raising it around the rest of the limb.13 Two designs, two trade-offs: the ETD gives up the bar to keep the steps few.
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03
Quick-Grip Roll Control
Tabs along the wrap keep the bandage from unrolling during application.3 The Defense Logistics Agency's item description puts it precisely: four hook-and-loop securing strips, equally spaced along the dressing.7
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04
Two widths, one 56 in. wrap
The 4 in. ETD carries a 6 × 4 in. pad, weighs 2.6 oz and packs to 4.5 × 2.5 × 1.75 in. The 6 in. carries a 6 × 6 in. pad, weighs 4 oz and packs to 6 × 2.5 × 2.1 in. Both wraps are 56 in. long.3,4 The 6 in. covers more wound; the 4 in. rides smaller.
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05
NSN-coded in both widths
4 in.: NSN 6510-01-558-4108. 6 in.: NSN 6510-01-558-4114.4 Both are issued one each, and the DLA records list NAR items 30-0031 and 30-0032 against them.7
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06
Sterile pad, latex-free build, Class I
FDA lists the ETD as an elastic bandage (product code FQM, 21 CFR 880.5075): Class I, exempt from 510(k). It is sterile, single use, and labeled as not made with natural rubber latex; every package carries a lot number and an expiration date.6
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07
Low-cube vacuum pack, red tear notches
Each dressing is vacuum-sealed in low-cube packaging with NAR's Red-Tip Technology® red tear notches, so it opens without a blade.3 A printed tag on the roll reads OTHER SIDE TOWARD WOUND — the pad side goes down.4
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08
One product, one job
A complete bleeding kit carries four products for four jobs: a tourniquet, packing gauze, a pressure dressing and a chest seal. The ETD is the pressure dressing. It does not replace a tourniquet on a limb a tourniquet can control, it is not a hemostatic, and it does not seal a chest wound.1
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09
Its place in TCCC
The TCCC Guidelines convert limb tourniquets to hemostatic or pressure dressings as soon as three criteria are met — the casualty is not in shock, the wound can be watched closely, and the tourniquet is not controlling an amputation — with every effort made to convert in under 2 hours.1 That conversion is a trained provider's call, made by protocol — and in simulation, converting to a pressure dressing took longer than converting to another tourniquet.15
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10
The dressing responders actually reach for
In the DoD Prehospital Trauma Registry, the pressure dressing was the most common intervention performed by battlefield first responders with no medic in the chain of care — 12 of 29 casualties.11 Across 50 mass-casualty patients in Afghanistan, tourniquets and pressure dressings were the most common prehospital interventions.10
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11
Firm pressure — not a tourniquet
NAR's direction: firm pressure, but never so tight it creates a tourniquet effect. Too tight, and the wrap closes the veins while the artery keeps pumping in — a venous tourniquet that builds pressure in the whole limb; NAR describes a reviewed case that ended in fasciotomies and loss of the leg.8,9 Feel is not a gauge: in 116 measured applications by EMS providers, pressures ran from 50 to 412 mmHg and did not match how tight providers thought they were.12 In cadaver legs, high-stretch wraps raised compartment pressure more than three times as much as low-stretch ones.14
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12
More than a bandage
The ETD also slings and swathes an arm, secures a splint to a limb, and does any other job that needs an elastic wrap.3
How to apply the ETD
In doctrinal order — the tourniquet and packing decisions come first, the dressing last.
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1Tourniquet first on a limb. Life-threatening limb bleeding a tourniquet can control gets a tourniquet. Hasty: high and tight over clothing, under threat or when you cannot see the source. Deliberate: on bare skin 2–3 in. above the wound once it is exposed. Never across a joint.1
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2Pack a wound that is deep. Deep wounds and junctional wounds — groin, armpit, neck — are packed first: the power ball goes in first, directly on the bleeding vessel, and every corner is packed tight. Never pack the chest or abdomen. The neck can be packed with care without compressing the airway; the lower neck above the collarbone is acceptable.
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3Hold pressure. Hemostatic gauze: at least 3 minutes, or the time on its label.1 Plain gauze: at least 10 minutes. In every case, until the bleeding stops — best practice is to keep holding until someone relieves you.
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4Open and orient. Tear the package at a red notch. The pad goes on the wound; the printed tag reads OTHER SIDE TOWARD WOUND.3,4
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5Wrap with a little stretch. Pull a little stretch on each pass and wrap around the limb, covering the pad completely. The Quick-Grip tabs keep the roll from unrolling as you go.3,9
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6Secure the end. Fasten the end with the securing device's hook-and-loop, or tuck it under the last wrap so it sits tight.9
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7Check beyond the dressing. Color, warmth, sensation and pulse below the wrap, compared with the other limb. If the skin turns dusky, capillary refill slows, pain climbs or the pulse fades, take the dressing down and reapply it with less force — then keep reassessing.8
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8If blood comes through. On a superficial wound, or a wound under the dressing that is not deep enough to pack, leave the dressing in place and add gauze and pressure on top. That rule does not cover a packed wound: if a packed wound keeps bleeding, remove the packing and repack — find the source, power ball first, every corner tight.1
Where it fits
- Bleeding a pressure dressing can hold — DLA's item description lists mild to moderate hemorrhage7
- Holding hemostatic or plain gauze under pressure once a deep or junctional wound is packed
- A pressure dressing after a trained provider converts a limb tourniquet1
- Slinging and swathing an arm, or securing a splint3
- Life-threatening limb bleeding a tourniquet can control — tourniquet first1
- An open or sucking chest wound — a vented chest seal, or a non-vented seal if no vented seal is available1
- Packing into the chest or abdomen — never
- Wrapping tight around the neck — the airway comes first
- Practice with a live, sterile dressing
The evidence
No peer-reviewed study of the ETD itself is indexed in PubMed. The studies below tested pressure dressings as a class or the Israeli-type Emergency Bandage, and the TCCC documents set the role.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| TCCC Guidelines, 1 May 2026 | Expert review · guideline | Massive hemorrhage, tourniquet conversion, open chest wounds | Tourniquet for limb bleeding it can control; hemostatic dressings ≥3 min of pressure; convert tourniquets to hemostatic or pressure dressings when three criteria are met; vented chest seal for an open chest wound |
| Evidence-Based Standard Devices & Adjuncts, 15 December 2021 | Expert review · device list | Devices recommended for combat casualty care | Limb tourniquets and hemostatic dressings and devices are named; there is no pressure-dressing category |
| Schauer et al., Prehosp Disaster Med 2017 | Human · combat registry | 50 mass-casualty patients, DoD Trauma Registry and Prehospital Trauma Registry, Afghanistan | Tourniquets and pressure dressings were the most common prehospital interventions; 97% of the 36 with follow-up survived to discharge |
| Paulson et al., Med J (Ft Sam Houst Tex) 2021 | Human · combat registry | 29 casualties treated only by battlefield first responders, Prehospital Trauma Registry 2003–2019 | Pressure dressing was the most common intervention (12), ahead of limb tourniquets (4) |
| Brauckmann et al., Eur J Trauma Emerg Surg 2026 | Human volunteer · simulation | 124 EMS providers applying pressure dressings to one volunteer's forearm over calibrated sensors; 116 analyzed; ETD not among the materials | Peak pressure 169 ± 84 mmHg (range 50–412); Israeli bandage 205 mmHg, with 28% of applications above 250 mmHg; self-assessed tightness did not match measured pressure |
| Shipman & Lessard, Mil Med 2009 | Human · pressure measurement | Emergency (Israeli) Bandage with and without its pressure bar, sensors under the bar and around the arm | The bar raised pressure directly under it without adding pressure elsewhere; fingertip perfusion and the radial pulse stayed adequate |
| Kwok et al., Mil Med 2026 | Cadaver · synthetic model | Low-, moderate- and high-stretch circumferential dressings on a pressurized manikin arm and cadaver legs | High-stretch dressings raised compartment pressure the most (cadaver anterior compartment +10.7 vs +3.0 mmHg for low-stretch) |
| Kragh et al., J Spec Oper Med 2021 | Manikin · simulation | 100 simulated tourniquet applications and conversions by one operator, including conversion to a pressure dressing | Conversion to a pressure dressing took longer than conversion to a tourniquet; a short wrap was swapped for longer ones to cover limbs better |
Strongest to weakest: human clinical and registry data, then human-volunteer measurements, then cadaver, manikin and bench work. The registries count how often pressure dressings were used, not how well any one brand performed.
How it compares
The ETD sizes and formats a buyer chooses between — same pad-on-wrap design, different footprints.
| ETD 4 in. rolled | ETD 6 in. rolled | Flat ETD 4 in. | Flat ETD 6 in. | ETD 8 × 10 in. | |
|---|---|---|---|---|---|
| NAR item | 30-0031 | 30-0032 | 30-0093 | 30-0094 | 30-0165 |
| Elastic wrap | 4 × 56 in. | 6 × 56 in. | 4 × 56 in. | 6 × 56 in. | 4 × 70 in. |
| Pad (H × W) | 6 × 4 in. | 6 × 6 in. | 6 × 4 in. | 6 × 6 in. | 8 × 10 in. |
| Packaged | 4.5 × 2.5 × 1.75 in. | 6 × 2.5 × 2.1 in. | 4.25 × 2.75 × 0.875 in. | 6 × 3.5 × 0.875 in. | 4.125 × 7 × 1 in. |
| Weight | 2.6 oz | 4 oz | 2.6 oz | 4 oz | 4 oz |
| NSN | 6510-01-558-4108 | 6510-01-558-4114 | No NSN | No NSN | 6510-01-654-6801 |
Rolled and flat figures from North American Rescue's product information sheets;4,5 ETD 8 × 10 in. figures and NSN from NAR's product page.17 Pad dimensions are height × width.
Build the system
The tourniquet and gauze that come first, the other ETD formats, the chest seal it does not replace, and the trainer.
Questions buyers ask
Package & specifications
Available Options:
- 6"
- 4"
Specifications coming soon. Contact us for detailed product information.
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