The Glia Tourniquet Project
A tourniquet prevents hemorrhagic death by constricting blood flow, for a period of time, to an injured extremity (arm or leg). It is used as the final step of a three-part wound care protocol which includes applying pressure to the wound, packing it with gauze, then applying a tourniquet proximal to the wound.
The tourniquet is comprised of long flexible strapping with hook & loop fasteners, which is attached to four different components on one end: a clip, buckle, windlass, and backing plate. The strapping wraps around the limb and adheres to the hook & loop securing it in place. Pressure against the bleeding wound is then applied by twisting the windlass until the blood flow stops, at which point the windlass is secured in the clip, allowing the tourniquet to maintain consistent pressure on the wound until it is removed.
A tourniquet is an important tool for medics and trauma first respondents stabilizing gunshot and penetrating wound victims, and especially for victims who are a considerable distance away from tertiary medical centers.
For patients in under-resourced areas, a simple medical device like a tourniquet may not be available due to import constraints or supply chain gaps. As a result, many victims of non-fatal injuries could potentially die due to severe bleeding before they can be treated at medical centers.
In 2016, Gaza Ministry of Health emergency medicine providers, led by Dr. Mohammed Al-Attar, determined that there was a significant need for improved hemorrhage control beyond what “first-aid” style tourniquets could provide, which are traditionally comprised of a belt or a sheet/stick combination. The Combat Application Tourniquet (CAT) performed effectively but due to the blockade of the Gaza strip, it was impossible to import these devices.
By 2017, The Hayat Center for Emergency and Crisis Management began a Stop The Bleed campaign to reduce or eliminate mortality due to limb blood loss, and it became apparent that clinically dependable tourniquets were a critical part of the campaign success. Manufacturing CAT-style tourniquets within Gaza was then explored. Glia Gaza engineers began developing tourniquet prototypes using additive manufacturing (3D Printing) and released the design on GitHub February 27, 2017.
In 2018, the Glia tourniquet was deployed as an emergency use device in response to excessive traumatic injuries during the Great March of Return. Since then, Glia has collaborated in countless hours of research with Gaza’s four paramedic services, hospitals, and ministries to refine the design, including field testing on trauma patients under live fire.
In 2022, Glia publicized the tourniquet design for use in Ukraine and researched an open-source injection mold to increase the availability of this life-saving device, the desktop version of which Glia Poland began documenting in 2023 on the Glia Tourniquet GitHub. Additionally in 2023, The Glia Tourniquet team published their collaboration on the world’s first open-source tourniquet tester with FAST Research Group at Western University.
Due to the blockade and ongoing conflict in Gaza, it was an imperative objective that Glia’s tourniquet be developed using a rapid and portable manufacturing process which could be performed within Gaza as shipments to the area were frequently intercepted and denied entry. Furthermore, regional power cuts interrupted traditional means of production. From an operational perspective, it was determined that the tourniquet should be 3D Printed using solar power and made open source, allowing anyone with access to a printer and electricity to manufacture tourniquets within their respective location.
Since commercially available tourniquets have both adult and pediatric versions, Glia also wanted to develop a one-size-fits-all product, allowing a single device to save the life of a victim regardless of age or limb size.
The Glia tourniquet has been successfully designed for both adult and pediatric use. It can be self-applied one-handed or externally applied by a medical responder onto a patient’s limb. It has saved the lives of hundreds of gunshot, explosive, and trauma victims - most notably during the 2018–2020 Great March of Return in which 5,969 people were shot (86.9% in the arms or legs). Despite this, only 2 died of their injuries, a remarkably low 0.03% fatality rate.
The Glia Tourniquet can be manufactured with a 3D printer and easily sourced fabric materials for a total material cost of USD$7. Glia, accounting for all other associated production costs, is currently able to maintain a retail price of CAD$30. Comparably, most commercial tourniquets retail cost ranges from USD$30-USD$50. Glia manufactures the tourniquet in both Canada and Gaza under a Health Canada Medical Device Establishment License (License #6823) to produce Class 1 devices.
Since 2017, over 2500 tourniquets have been successfully deployed in Gaza by field medics, emergency medicine physicians, and trauma first responders. Glia’s dedication to research and field testing has saved many lives in Gaza and beyond, as all research and design files are open sourced to create equal care for all.