Table 1. Characteristics of Included Studies for the Pediatric Tourniquet Systematic Review.

CAT: Combat Application Tourniquet

Study	Study design	Intervention	Comparison	Participants	Setting	Key Results	Risk of bias (ROBINS-I)
Harke 2019 [10]	Observational	Combat Application Tourniquets (C-A-T®) (120 applications)	No comparison	Sixty participants 6-16 years of age were recruited as a convenience sample from an orthopedic clinic and had a CAT Generation 7 applied to one upper extremity at the mid-biceps level and one lower extremity at the mid-thigh level.  A non-injured extremity was used.	Outpatient orthopedic clinic. All tourniquets were applied by the researchers and no apparent blinding occurred.  Successful application was determined by cessation of the distal pulse by Doppler with a maximum of three windlass turns to limit pain.	The CAT was successful in occluding arterial flow in 100% (60/60) of upper extremities and 93% (56/60) lower extremities. Distal pulses occlusion occurred in both upper and lower extremities of children age six and over with a limb circumference ≥16 cm.  Three applications in the lower extremity failed to occlude pulses after three windlass turns and on one application a participant withdrew due to pain.	Critical
Kelly 2020 [11]	Observational	Combat Application Tourniquets (C-A-T®) (24 applications)	No comparison	Thirteen participant age two to seven years.  A non-injured extremity was used. Successful application was determined by cessation of the distal pulse by Doppler.	Children undergoing elective orthopedic surgery while under anesthesia.   All tourniquets were applied by the researchers and no apparent blinding occurred.  The outcome was cessation of distal pulse as detected by doppler.	Tourniquets were placed on 24 limbs (11 upper extremities and 13 lower extremities) with a 100% success rate in occluding distal pulses. The minimal limb circumference tested was 13 cm in a two year-old child.	Critical