The JETT takes over the pressure your hands are holding on a groin wound — but only if the pads land just below the inguinal ligament and the belt has no slack in it.
At a glance
12 things to know about the JETT
What it is cleared for, where the pads go, and what the cadaver, manikin and volunteer studies found.
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01
It covers the gap a limb tourniquet leaves
The JETT is FDA-cleared for emergent use to control difficult bleeds in the inguinal area.4 North American Rescue built it for high thigh and groin wounds where a tourniquet cannot be placed or works poorly — penetrating trauma, blast injuries and amputations are its examples.5,6 Among U.S. combat deaths from 2001 to 2011, junctional bleeding accounted for 19.2% of the potentially survivable hemorrhage deaths.19
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02
Two pads on one belt — both legs at once
Each pad sits on its own threaded T-handle and is tightened independently, so one belt treats one groin or both.4,5 Both pads come pre-positioned, so the bilateral application is the same drill as the single one. In perfused cadavers, a bilateral JETT went on in 10 seconds against 68 seconds for two Combat Ready Clamps applied one after the other.9
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03
Pad placement decides whether it works
The pads go immediately below the inguinal ligament — the line between the point of the hip bone and the pubic bone — angled about 30° so they run parallel to it, pointing toward the midline and the feet.5 A post-mortem CT review of one casualty with non-survivable blast injuries found one pad turned vertical with only its lower portion below the ligament; the reviewers' conclusion was that accuracy in targeting the pressure point is essential.17
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04
No slack before you turn a handle
North American Rescue's instructions call for buckling the belt and pulling it firmly tight — all slack out — before either pad is screwed down.5 When Special Operations students tested it, 9% of JETT applications failed to stop flow on one side, and the evaluators found that a belt not tightened before the pad is threaded down compromises occlusion.12
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05
Screw down to the endpoint
With one hand on the base plate, turn the T-handle clockwise until bright red bleeding stops; if the limb is intact, check that the pulse in the foot is gone.5 Expect it to hurt — in human volunteers, pain differed from one junctional model to the next.10
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06
A locking toggle holds it through transport
A lanyard and tactical toggle lock each T-handle so vibration and bumps cannot unwind the pressure.5,6 Movement is still the weak point of every junctional device: after a short transport of volunteers, effectiveness fell to 24–48% across the JETT, SAM Junctional Tourniquet and CRoC, with the SAM device holding better than the JETT.11 Reassess after every move.
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07
Four hours, groin only
The clearance describes control of bleeding for up to 4 hours until the casualty can be moved to treatment, and the instructions carry two warnings: do not leave it on longer than 4 hours, and inguinal use only.4,5 It is not cleared for the armpit.
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08
It is not labeled as a pelvic binder
The belt does compress the pelvis, and a two-cadaver CT study found the JETT brought an open-book (APC III) pelvic ring injury close to its pre-injury dimensions.16 Its clearance and instructions, though, cover inguinal bleeding only.4,5 For a suspected pelvic fracture, the TCCC Guidelines call for a pelvic binder.1
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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 In practice your hands go on the wound with Combat Gauze first; the JETT then holds the pressure so you can move on.4
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10
What the head-to-head studies found
In human volunteers, the CRoC, SAM Junctional Tourniquet and JETT were the most effective of four models, with no significant difference among them.10 A meta-analysis of volunteer studies put average JETT effectiveness at 83% and its mean application time at 130 seconds, against 101 for the SAM device and the CRoC.15 Special Operations students rated the JETT above the CRoC and applied it about 15 seconds faster;12 on a bleeding manikin, the JETT lost more simulated blood than the CRoC and SAM device.14
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11
Training is the difference
In a randomized crossover trial at Fort Hood, only 28% of combat lifesavers and 40% of combat medics placed both the JETT and the SAM Junctional Tourniquet successfully, and both groups preferred the SAM device.13 The JETT belongs with providers who have practiced pad placement until the landmarks are automatic.
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12
Rarely used, and no longer named by the evidence-based
The Department of Defense Trauma Registry recorded 39 junctional tourniquet placements among 48,301 casualty encounters from 2007 to 2023.18 The 2019 Evidence-Based Standard Devices list named the JETT (NSN 6515-01-616-58418) alongside the CRoC and SAM Junctional Tourniquet;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 JETT is cleared for inguinal bleeding, so it falls within that rule.
How to apply the JETT
North American Rescue's 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 JETT.1
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2Confirm the wound needs it. The bleeding is high in the thigh or groin, where a standard tourniquet cannot control it. Decide whether one side or both need a pad.5
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3Clear the area. Remove gear, pocket contents and debris that would sit under the belt or the pads.5
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4Slide the belt under the hips. The side marked "This Side Toward Casualty" faces up as it passes under the lower back; lift the hips and center the buttocks pad behind the casualty.5
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5Set the pads. Find the point of the hip bone and the pubic bone — the inguinal ligament runs between them. Place each pad immediately below the ligament, angled about 30° parallel to it and pointing toward the feet, with the genitals clear.5
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6Buckle and take out all slack. Pull the loop handle firmly while your other hand stabilizes the belt, then recheck that the pads are still below the ligament.5
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7Screw it down. With a hand on the base plate, turn the T-handle clockwise until bright red bleeding stops; if the limb is intact, confirm the foot pulse is gone.5
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8Lock it. Put the toggle through the opening in the T-handle and cinch it tight at the base plate. Repeat on the other side for a bilateral injury.5
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9Write the time. Note the application time on the writable area of the belt and on the casualty card.1,5
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10Reassess and hand it off. Check every 5 minutes, and after any movement, that the pads are still in place and the bleeding is still controlled. Leave it on for the receiving team: the instructions reserve removal for physician supervision or your medical protocol, and it never stays on beyond 4 hours.5
Where it fits
- Groin and high-thigh bleeding a limb tourniquet cannot control — one side or both
- Bilateral high-leg injuries, where one device covers both femoral arteries
- Holding pressure on a packed groin wound so your hands are free for other casualties4
- Transport with the device locked in place, reassessed after every move5
- Armpit bleeding — the JETT is labeled for inguinal use only5
- Limb bleeding a tourniquet can control — limb tourniquet first1
- Binding a suspected pelvic fracture — use a pelvic binder1
- More than 4 hours of continuous use5
- The MRI suite — the JETT is MR Unsafe7
The evidence
Every study cited above, what it tested, and how strong the evidence is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Gates et al., J Spec Oper Med 2014 | Cadaver · perfused model | JETT vs CRoC vs a limb tourniquet, groin bleeding, 3 perfused cadavers | JETT and CRoC both stopped femoral flow at normal pressure; bilateral JETT in 10 s vs 68 s for two CRoCs |
| Kragh et al., Prehosp Emerg Care 2015 | Human · volunteers | CRoC, AAJT, JETT and SAM Junctional Tourniquet on 10 volunteers; distal pulse by Doppler | CRoC, SAM device and JETT most effective, no significant difference; CRoC and SAM device fastest; pain varied by model |
| Gaspary et al., Prehosp Emerg Care 2019 | Human · randomized volunteers | CRoC, JETT and SAM Junctional Tourniquet applied by 49 corpsmen to fellow participants, then a short transport | JETT and SAM device faster than CRoC; similar effectiveness; after transport the SAM device held better than JETT, all 24–48% |
| Theodoridis et al., J Spec Oper Med 2016 | Human · volunteers | JETT vs CRoC, rated by 75 Special Operations students; 33 timed applications | JETT preferred and about 15 s faster; 9% of JETT applications failed to occlude one side |
| Flecha et al., Mil Med Res 2018 | Manikin · randomized crossover | JETT and SAM Junctional Tourniquet applied by 133 combat lifesavers and 94 combat medics | 28% of combat lifesavers and 40% of medics placed both successfully; both groups preferred the SAM device |
| Kragh et al., Prehosp Disaster Med 2016 | Manikin | CRoC, JETT and SAM Junctional Tourniquet, 30 users, 270 tests on a bleeding groin manikin | All controlled the bleeding; the JETT had more blood loss than the CRoC and SAM device |
| Smith et al., J Trauma Acute Care Surg 2019 | Expert review · meta-analysis | Eight healthy-volunteer studies of four junctional devices | Average effectiveness JETT 83%, SAM device 87%, CRoC 95%; mean application 130 s for JETT vs 101 s; transport untested |
| Gary et al., J Spec Oper Med 2014 | Cadaver · CT imaging | JETT applied to 2 cadavers with a created open-book (APC III) pelvic ring injury | Near-anatomic reduction of the pelvic ring — outside the JETT's cleared indication |
| Harcke et al., AFMES Feedback to the Field #16 | Human · autopsy review | Post-mortem CT of one casualty treated with a JETT | One pad mispositioned; accuracy in targeting the pressure point judged essential |
| Reneau et al., J Spec Oper Med 2024 | Human · registry | Department of Defense Trauma Registry, 2007–2023 | 39 junctional tourniquet placements in 48,301 encounters, mostly in polytrauma |
| 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, manikin and healthy-volunteer work, plus small registry and case data — 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.
| JETT | SAM Junctional Tourniquet | AAJT-S | CRoC | |
|---|---|---|---|---|
| Mechanism | Two screw-down pressure pads on a belt | Hand-pumped target compression device on a force-limiting belt | Hand-pumped wedge bladder on a ratcheting belt | Aluminum clamp with a screw-down pressure disc |
| FDA-cleared for | Inguinal bleeding | Inguinal and axillary bleeding; pelvic fracture immobilization | 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 — two pads | Yes — the JT400-EN kit carries two compression devices | 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 | 1 lb 8 oz | 24 oz (JT400-EN) | 25 oz | 1.25 lb |
| Volunteer effectiveness (meta-analysis) | 83% | 87% | Earlier AAJT: 52% abdominal; groin 100% in 2 studies | 95% |
| Mean application time (meta-analysis) | 130 s | 101 s | Earlier AAJT, abdominal: 92 s and 171 s | 101 s |
| Named on the 2019 evidence-based list | Yes | Yes | — | Yes |
Indications and labeled times come from each device's FDA 510(k) record and instructions;4,5,20,21,22 weights from the manufacturers' published specifications;6,20,21,22 effectiveness and application times are averages from healthy-volunteer studies.15
Build the system
The carrier for the JETT, the packing that goes in first, the other junctional options and the training aid.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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