CAT

Question 1

Indications

Answer 1

“Sally Couldn’t Break Sam”
Severe bleeding from limb that cannot be controlled from direct, firm and sustained pressure
Crush injury of limb with weight on for more than 60 minutes prior to release
Bleeding from limb that is life threatening
Severe bleeding from limb and the site of bleeding cannot be reached

Question 2

Contraindications and cautions

Answer 2

None

Question 3

MOA

Answer 3

CAT works by compressing BV against the bone by using circumferential pressure.

Question 4

Where do you place CAT?

Answer 4

Not over a joint

Three fingers or 5cm proximal to wound

Question 5

When can you reevaluate need for CAT?

Answer 5

Bleeding controlled

IV access obtained and fluid rests started

Question 6

What are the post application checks

Answer 6

Reassess LB
The bleeding has stopped
The skin is pale
Absent distal pulse 
Time has been written on CAT of application

Question 7

How many rotations are required

Answer 7

Less than three complete rotations OR until bleeding has stopped and no distal pulse

Question 8

Procedure

Answer 8

Assess LB
Expose wound and limb
Apply CAT
Tighten
Leave wound exposed
Complete post application checks
Document application

Question 9

Complications

Answer 9

Severe pain
Tissue damage
If CAT applied to limb with two bones a second may need to be applied proximal to first.
If CAT applied to thigh esp if large and bleeding does not stop apply another one proximal to the first.