Made in Israel & available in the USA via MED-TAC International
As combatants and field professionals, the folks at TW Medical in Israel experienced the need for a functional, practical, and easy-to-use tourniquet. They translated this need into the LST tourniquet, which enables treatment of both standard limb injuries and injuries in proximal areas
Introducing the LST - Life Saving tourniquet
The LST Tourniquet is a functional, practical and simple to use tourniquet. Unlike traditional tourniquets, the LST can stop bleeding from proximal areas in addition to stopping limb bleeding.
For injuries to the arms and legs, the LST functions like a standard tourniquet. However, in cases of injuries to the shoulder or upper thigh—or even complete amputations—the LST applies pressure to the main artery leading to the limb using a dedicated pressure pin, effectively stopping the bleeding.
Effective for limb injuries
The LST is effective and quick to apply to the limb. It can also be applied with one hand.
Effective in proximal areas
LST has unique characteristics that enable it to treat injuries that require pressure points.
Practical in extreme conditions
The LST is extremely durable. Its simplicity allows for operation even under extreme pressure conditions and during combat.
Compact and lightweight
The LST is lightweight and compact. It fits well in many vests and pouches, and it is able to be open quickly.
How to Use the LST Tourniquet?
Using the LST tourniquet is simple and effective:
– For limb injuries: Place the LST above the injury site, just like a standard tourniquet. Tighten the strap and rotate the rad until the bleeding stops. Then, secure the rad and strap.
– For proximal injuries: Position the LST so that the pressure pin applies force on the main artery leading to the limb. Tighten the strap firmly and, if needed, use the rad to create additional pressure.
The strap length is 155 cm (about 61 inches), plenty of material to be able to go around those with significant tactical midsection girth.
TWM developed the LST, which provides on-site solutions for both bleeding from proximal areas and limb bleeding. Additionally, TWM has successfully passed the Israeli Standards Institute's accreditation exams and received approval to develop and manufacture medical products (ISO13485). The LST is protected by both Israeli and international patents and has received approval from the Israeli Ministry of Health (AMAR).
Patents:
Israel Patent No. 303402 – Granted
US Patent Application No. 19/058,548 – Notice of Allowance received (patent granted)
PCT Application No. WO2024246888A1 – Published, providing global coverage
India Patent Application No. 202517028448 – Filed, currently under review
Clinical Research: The LST clinical study has been accepted for publication in a journal of traumatology. It was conducted at Shaare Zedek Medical Center in Jerusalem and demonstrates the LST’s effectiveness for proximal hemorrhage control.
We will continue to post research as it becomes available.
Field Use Summary: The product was tested in a training exercise with combat soldiers, focusing on ease of use and time to bleeding control. Results showed that even non-medical personnel could use it effectively after a brief training.
On a personal note: We had asked Yaakov Tsadik, the inventor of the LST for a quick background and history of the device, because devices like these usually tend to have a story, right? This is the beautiful email we received.
Marco,
I totally understand the need for more independent studies. The IDF is about to run an evaluation of the LST, and plans to publish their own findings.
As for the background story:
A few years ago, I volunteered with Magen David Adom. That’s where I first encountered the challenge of junctional bleeding. One of my friends ended up hospitalized with necrosis in two fingers after trying to apply a Manual Pressure Point during a trauma case — it nearly led to amputation.
Later in the army, during a training exercise, a friend of mine was shot in the shoulder. My instinct was to apply Manual Pressure Point, but a commander stopped me, reminding me that in real combat I’d have to keep fighting — not stop to treat him. That moment stuck with me. If it were real, my friend would have bled out in minutes — and there was nothing I could’ve done.
I kept thinking: if it were a limb injury, I could’ve just applied a tourniquet and gone back to the fight. But for junctional wounds, I had no solution.
Over time, I started forming one: a compact, practical tool that could act as both a standard tourniquet and a way to stop junctional bleeds — simple enough for any soldier or responder to use.
The problem of junctional bleeding is well known in trauma care, so I wondered why no one had done it already. But after two years of trial and error — with countless failed prototypes — I understood why no one had. Together with Dr. Giora Weiser, we eventually arrived at a working, clinically effective device.
Shortly after my discharge, I founded the company. Two years later, the LST was ready for market — and now, with growing adoption and awareness, I’m hopeful it will go on to save many lives.
What is the LST? A compact hemorrhage-control device that works as both a standard limb tourniquet and a targeted-pressure junctional tourniquet for the groin (femoral) and armpit (axillary) regions.
How does it control junctional hemorrhage? A shaped pressure element (often called a pin or cone) is positioned over the proximal artery and tightened with the strap/buckle, creating focused compression where conventional limb tourniquets are ineffective.
Can it still be used as a regular limb tourniquet? Yes. The same device can be applied in “limb mode” for extremity bleeding or in “junctional mode” by engaging the pressure element over the artery.
Is it suitable for single-rescuer use? The strap/buckle layout is designed for rapid, intuitive application by one rescuer, but hands-on training is essential for correct landmarking and force.
Is it CoTCCC-recommended? As of 2025-10-25, the LST does not appear on the CoTCCC list of recommended limb tourniquets. Use it alongside CoTCCC-recommended limb tourniquets rather than as a replacement.
What validation or studies exist? Recent feasibility work describes the LST as a novel junctional tourniquet using a cone interface for femoral and supraclavicular targets. Additional field data will further define performance.
Regulatory or quality notes? The manufacturer reports ISO 13485 compliance and registration/approval with Israel’s Ministry of Health (AMAR). Always verify local procurement and agency requirements.
Who is it for? Trained first responders, medics, and agencies that want a single tool providing both limb and junctional control capability.
Any limitations? Effective junctional control requires precise placement over the target artery. Malposition can fail to stop bleeding or cause tissue injury. Practice with training aids is strongly recommended.
Care, monitoring, and documentation? Tighten until there is no distal pulse, secure the device, reassess frequently, monitor for complications, and document application time and any conversions.
Review date: 2025-10-25 · Selected sources: T-W Medical product information; 2025 LST feasibility study; public CoTCCC recommended device summaries.
Addresses bleeding at transition zones near the torso where standard circumferential limb compression loses mechanical advantage.
Creates a localized arterial occlusion point while preserving perfusion to non-injured territory distal and contralateral to the target site.
Provides a rapid option when direct pressure or packing is impractical (e.g., deep groin wounds, narrow access, limited manpower).
Hemodynamic reasoning
Effective control hinges on compressing the vessel against underlying bony structures to exceed systolic pressure at the target artery.
Concentrated surface force reduces the total strap tension needed for occlusion compared with broad, purely circumferential methods.
By minimizing the contact patch, the device can achieve a steeper pressure gradient over the arterial tract, facilitating faster pulse extinction at the site.
Clinical decision pathway (context of care)
For junctional groin/axilla wounds with brisk external hemorrhage, prioritize rapid focal arterial control before or alongside wound packing and pressure dressings.
In polytrauma, early control shortens the shock window and allows earlier transition to airway/ventilation and hypothermia prevention tasks.
When evacuation is prolonged, securement and periodic reassessment take precedence over repeated re-tightening that may destabilize clots.
Compared with purely manual pressure: provides mechanical consistency and frees the rescuer for other critical tasks.
Compared with packing alone: focal arterial compression can reduce bleeding enough to make subsequent packing effective instead of overwhelmed.
Compared with large junctional platforms: smaller footprint can be advantageous in confined spaces, vehicle extrications, or when patient positioning is constrained.
Patient safety & monitoring
Confirm loss of distal pulse in the target limb/region if assessable; reassess after movement, packaging, and transfers.
Watch for malposition, escalating pain out of proportion, or skin compromise at the pressure interface; correct rather than stacking additional devices.
Document application time, anatomic target, reassessments, and any conversions for receiving teams.
Evidence & Training Rationale (concise)
Emerging literature and manufacturer testing support the concept of focused arterial compression for junctional indications; ongoing field data will refine protocols across body habitus and gear/clothing barriers.
Skills emphasis should be on rapid arterial landmark identification (e.g., common femoral/axillary trajectory) and confirmation of effective occlusion, not merely “tightness.”
Training should incorporate scenario constraints—confined spaces, vehicle interiors, limited light, and single-rescuer timelines—to build reliable motor patterns.
Programs should track time-to-control, first-pass success, and complications to guide QA/QI and update local SOPs.
Implementation notes for kits & protocols
Stage as a complement to primary limb tourniquets and hemostatic gauze; specify indications and contraindications in SOPs to reduce hesitation at the point of injury.
Include quick-reference cueing (landmarks, pulse checks, securement points) on card or label to mitigate cognitive overload under stress.
Integrate into MARCH/THREAT flow so hemorrhage control steps remain consistent across limb and junctional scenarios.
Review date: 2025-10-25 · Selected sources: manufacturer technical materials; emerging peer-reviewed reports on focused junctional arterial compression; public summaries of prehospital hemorrhage-control guidelines.