GSWs to Leg and Groin: AAJT-S Fills Capability Gap for Junctional Hemorrhage on the Battlefield
A 21-year-old combat casualty in Afghanistan with three GSWs, hemorrhagic shock, and a transected left deep femoral artery survived after the AAJT-S was applied to the left inguinal crease — filling the capability gap a limb tourniquet cannot reach.
Location: Afghanistan
Authors: Croushorn J, et al. · J Spec Oper Med 2014;14(2):6–8
Setting: Military & Tactical · Battlefield
Application site: Left inguinal crease
Case ID: AF-3GSW-31
Clinical case summary
Synopsis
Injury, intervention, and outcome at a glance
- 3x GSW to leg and groin
- Lethargic & confused on assessment
- Hemorrhagic shock
- Transected left deep femoral artery
- Junctional zone — no extremity TQ option
- AAJT-S to left inguinal crease
- Extremity TQ for distal injuries
- 4 units O+ PRBCs administered
- Hemorrhage control achieved at POI
- Stabilized for evacuation
- Capability gap filled at point of injury
- Vascular repair completed
- No device-related complications
- Discharged post-op day 1
Combat trauma with junctional bleed
A 21-year-old male sustained three gunshot wounds to the left leg and groin on the battlefield. He arrived lethargic and confused, with clinical signs of hemorrhagic shock and a transected left deep femoral artery. The injury location, in the inguinal/junctional zone, lay outside the effective coverage of a standard extremity tourniquet.
Junctional bleeding beyond TQ reach
The bleeding source sat in the inguinal junctional zone — between abdomen and thigh, the exact region a limb tourniquet cannot encircle. Without proximal control, hemorrhage from the deep femoral transection would have outpaced any resuscitation the team could deliver in the field.
AAJT-S at the left inguinal crease
The AAJT-S was applied to the left inguinal crease, providing direct compression of the inguinal vessels at a site no limb tourniquet can reach. 4 units of O+ PRBCs were administered, and an extremity tourniquet was applied as an adjunct for the more distal injuries.
Vascular repair, discharged post-op day 1
Hemorrhage was controlled, hemodynamics stabilized, and the casualty was successfully evacuated. Surgical vascular repair was completed and the patient was discharged on post-operative day 1.
“AAJT-S fills the capability gap for junctional hemorrhage that limb tourniquets cannot reach.”
— Croushorn J, et al. · J Spec Oper Med 2014;14(2):6–8 · Afghanistan deployment
