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Original article
Martial arts technique for control of severe external bleeding
  1. John P Slevin1,
  2. Cierra Harrison2,
  3. Eric Da Silva3,
  4. Nathan J White1,4
  1. 1 Department of Bioengineering, University of Washington, Seattle, Washington, USA
  2. 2 Department of Arts and Sciences, University of Washington, Seattle, Washington, USA
  3. 3 Eric Da Silva Steel Blanket Brazilian Jiu-Jitsu, Woodinville, Washington, USA
  4. 4 Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Nathan J White, Department of Emergency Medicine, Harborview Medical Center, Seattle, WA 98104, USA; whiten4{at}uw.edu

Abstract

Objectives Haemorrhage control is a critical component of preventing traumatic death. Other than the battlefield, haemostatic devices, such as tourniquets or bandages, may not be available, allowing for significant avoidable blood loss. We hypothesised that compression of vascular pressure points using a position adapted from the martial art of Brazilian Jiu-Jitsu could be adapted to decrease blood flow velocity in major extremity arteries.

Methods Knee mount compression was applied to the shoulder, groin and abdomen of healthy adult volunteer research subjects from Seattle, Washington, USA, from March through May 2018. Mean arterial blood flow velocity (MAV) was measured using ultrasound in the brachial and femoral arteries before and after compression. A MAV decrease greater than 20% with compression was deemed clinically relevant.

Results For 11 subjects, median (IQR) MAV combining all anatomical locations tested was 29.2 (34.1, 24.1) cm/s at baseline and decreased to 3.3 (0, 19.1) cm/s during compression (Wilcoxon p<0.001). MAV was significantly decreased during compression for each individual anatomical position tested (Wilcoxon p≤0.004). Per cent (95% CI) MAV reduction was significantly greater than 20% for shoulder compression at 97.5%(94% to 100%) and groin compression at 78%(56% to 100%), but was not statistically greater for abdominal compression at 35%(12% to 57%). Complete vessel occlusion was most common with compression at the shoulder (73%), followed by groin (55%) and abdomen (9%) (χ² LR, p=0.018).

Conclusion The Brazilian Jiu-Jitsu knee mount position can significantly decrease blood flow in major arteries of the extremities. This technique may be useful for bleeding control after injury.

  • wounds
  • trauma, research
  • trauma, majot trauma management
  • trauma, extremity
  • prehospital care, first responders

https://doi.org/10.1136/emermed-2018-207966

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    Footnotes

    • Contributors NJW conceived the study, performed the experiments, performed the data analysis and drafted the manuscript. EDS inspired the study and provided critical technique training, suggestions and refinement. JPS assisted with subject recruitment and performed experiments. CH recruited study subjects, performed experiments and assisted with data analysis. All authors provided critical revisions to the manuscript and approved its final form.

    • Funding This project was supported by U.S. Department of Defense grant N00014-16-1-2708.

    • Competing interests EDS is owner of Eric Da Silva Brazilian Jiu-Jitsu, Woodinville, Washington, USA.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Study data are available on request to the senior author.