Although some of the commercial tourniquets that we’ll talk about can be used at other junctional areas, most of them have been designed with application to inguinal junctional hemorrhage in mind. Likewise, the improvised compression device we’ll review also primarily targets the inguinal region. Pelvic and inguinal hemorrhage have comprised the majority of the junctional bleeds that have been seen in recent conflicts. This is likely a function of the fact that body armor offers less protection to this area and many improvised explosive device injuries affect the lower body preferentially over the upper body.

The anatomy of the inguinal area does, however, offer easier access to the blood vessels for compression, and provides a mechanical advantage for maintaining pressure that is not seen in axillary and neck injuries. It is even possible to compress the aorta in some cases, although it is difficult to maintain adequate compression for an extended period of time.

The site of lethal hemorrhage was truncal (67.3%), followed by junctional (19.2%) and peripheral-extremity (13.5%) hemorrhage. (Eastridge, 2012)