What do the people who transport trauma patients know about tourniquets?

Background: The primary study objectives were to gather information concerning the tourniquet knowledge, experience, training, protocols, preferences, and equipment of civilian prehospital providers.

Methods: This is a survey of 151 prehospital care providers.

Results: Survey respondents included 27 basic, 1 intermediate, and 75 paramedic emergency medical technicians; 1 registered nurse; 4 firefighters without medical certifications; 2 respondents not yet certified; and 1 respondent not listing certifications.

Tourniquets and occlusion: the pressure of design.

Unlabelled: Nerve injuries result from tourniquet pressure. The objective was to determine arterial occlusion and completion pressures with the 3.8-cm-wide windlass Combat Application Tourniquet (CAT) and the 10.

Stretch and wrap style tourniquet effectiveness with minimal training.

Unlabelled: The objective was to determine if proper application of the Stretch, Wrap, and Tuck Tourniquet (SWAT-T) would stop arterial flow and would occur with minimal training.

Methods: Fifteen undergraduates watched a 19 second video three times, practiced twice, and applied the tourniquet to volunteers at 10 locations: 3 above the elbow or knee and 2 below.

Results: Successful occlusion (60 second Doppler signal elimination) was more frequent than proper stretch (96 versus 75), more frequent on arms than legs (59 versus 37), and achieved before completed application (16 +/- 8 versus 33 +/- 8 seconds; each p < 0.

Lighting did not affect self-application of a stretch and wrap style tourniquet.

Unlabelled: The objective was to determine the effects of darkness on self-application of a stretch and wrap style tourniquet.

Methods: Following training and practice, 15 volunteers self-applied the Stretch, Wrap, and Tuck-Tourniquet (SWAT-T) to their leg, thigh, dominant forearm, and dominate arm. Proper application in lighted conditions was followed by the same applications in darkness.