A Randomized Controlled Trial using iTClamp, Direct Pressure, and Balloon Catheter Tamponade to Control Neck Hemorrhage in a Perfused Human Cadaver Model.

J Emerg Med

Department of Surgery, Foothills Medical Centre, Calgary, Alberta, Canada; Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada; Department of Critical Care Medicine, Foothills Medical Centre, Calgary, Alberta, Canada; Canadian Forces Health Services Centre, Ottawa, Ontario, Canada.

Published: April 2019

AI Article Synopsis

  • Penetrating neck wounds are serious injuries that can lead to high rates of sickness and death.
  • Researchers compared the effectiveness of the iTClamp, direct manual pressure (DMP), and Foley catheter balloon tamponade (BCT) in controlling bleeding from neck wounds in a controlled cadaver study.
  • Results showed that both the iTClamp and BCT significantly reduced fluid loss compared to DMP and that the iTClamp was faster to apply, making it a beneficial option for managing severe neck bleeding.

Article Abstract

Background: Penetrating neck wounds are common in the civilian and military realms. Whether high or low velocity, they carry a substantial morbidity and mortality rate.

Objectives: We endeavored to ascertain whether the iTClamp is equivalent to direct manual pressure (DMP) and Foley catheter balloon tamponade (BCT).

Methods: Using a perfused cadaver, a 4.5-cm wound was made in Zone 2 of the neck with a 1-cm carotid arteriotomy. Each of the hemorrhage control modalities was randomized and then applied to the wound separately. Time to apply the device and fluid loss with and without neck motion was recorded.

Results: There was no significant difference between the fluid loss/no movement (p > 0.450) and fluid loss/movement (p > 0.215) between BCT and iTClamp. There was significantly more fluid lost with DMP than iTClamp with no movement (p > 0.000) and movement (p > 0.000). The iTClamp was also significantly faster to apply than the Foley (p > 0.000).

Conclusions: The iTClamp and BCT were associated with significantly less fluid loss than DMP in a perfused cadaver model. The iTClamp required significantly less time to apply than the BCT. Both the iTClamp and the BCT were more effective than simple DMP. The iTClamp offers an additional option for managing hard-to-control bleeding in the neck.

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Source
http://dx.doi.org/10.1016/j.jemermed.2018.12.008DOI Listing

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