Background: Combat applications of tourniquets for extremity trauma have led to increased civilian prehospital tourniquet use. Studies have demonstrated that appropriate prehospital tourniquet application can decrease the incidence of arrival in shock without increasing limb complications. The aim of this study was to examine outcomes of prehospital tourniquet placement without definitive vascular injury.
Methods: Retrospective review was performed of a prospectively maintained database by the American Association for the Surgery of Trauma from 29 trauma centers. Patients in this subset analysis did not have a significant vascular injury as determined by imaging or intra-operatively. Patients who received prehospital tourniquets (PHTQ) were compared to patients without prehospital tourniquets (No-PHTQ). Outcomes were amputation rates, nerve palsy, compartment syndrome, and in-hospital mortality.
Results: A total of 622 patients had no major vascular injury. The incidence of patients without major vascular injury was higher in the PHTQ group (n = 585/962, 60.8 vs n = 37/88, 42.0%, < .001). Cohorts were similar in age, gender, penetrating mechanism, injury severity scores (ISS), abbreviated injury score (AIS), and mortality ( > .05). Amputation rates were 8.3% (n = 49/585) in the PHTQ group compared to 0% (n = 0/37) in the No-PHTQ group. Amputation rates were higher in PHTQ than No-PHTQ with similar ISS and AIS ( = .96, = .59). The incidence of nerve palsy and compartment syndrome was not different ( > .05).
Conclusions: This study showed a significant amount of prehospital tourniquets are being placed on patients without vascular injuries. Further studies are needed to elucidate the appropriateness of prehospital tourniquets, including targeted education of tourniquet placement.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/00031348221088968 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Is the Use of Tourniquets More Advantageous than Other Bleeding Control Techniques in Patients with Limb Hemorrhage? A Systematic Review and Meta-Analysis.
Medicina (Kaunas)
January 2025
Department of Surgery, General Surgery, Sapienza University of Rome, 00185 Roma, Italy.
Trauma, particularly uncontrolled bleeding, is a major cause of death. Recent evidence-based guidelines recommend the use of a tourniquet when life-threating limb bleeding cannot be controlled with direct pressure. Prehospital hemorrhage management, according to the XABCDE protocol, emphasizes the critical role of tourniquets in controlling massive bleeding.
View Article and Find Full Text PDFIncreasing prehospital tourniquet use attributed to non-indicated use: an 11-year retrospective study.
Eur J Trauma Emerg Surg
January 2025
Department of Traumatology, John Hunter Hospital, Newcastle, NSW, 2310, Australia.
Purpose: The use of prehospital tourniquets (PHTQ) for haemorrhage control in the civilian trauma population has increased over the past decade with some reports documenting the overuse of the device. The aim of this study was to identify the proportion of PHTQ use that is non-indicated and determine how this proportion is changing over time.
Methods: An 11-year retrospective study was performed at a Level-1 Trauma Centre on all trauma patients admitted with a PHTQ.
Available equipment for traumatic haemorrhage management in Austrian prehospital physician response units: a nationwide survey and analysis of guideline adherence.
BMC Emerg Med
December 2024
Department of Anaesthesiology and Intensive Care Medicine 1, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Background: Traumatic injuries, particularly those involving massive bleeding, remain a leading cause of preventable deaths in prehospital settings. The availability of appropriate emergency equipment is crucial for effectively managing these injuries, but the variability in equipment across different response units can impact the quality of trauma care. This prospective survey study evaluated the availability of prehospital equipment for managing bleeding trauma patients in Austria.
View Article and Find Full Text PDFThe cost of saving lives: Complications arising from prehospital tourniquet application.
Acad Emerg Med
December 2024
Department of Emergency and Disaster Management, School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv-Yafo, Israel.
Background: Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors.
View Article and Find Full Text PDFThe Bleeding Must Be Stopped! Management in the Situation of Hemorrhages-A Prospective Randomized Controlled Prospective Simulation Study.
Healthcare (Basel)
November 2024
Emergency Medicine Department, Medical University of Silesia, 40-055 Katowice, Poland.
Introduction: In a pre-hospital setting, uncontrolled hemorrhages in patients are undoubtedly a highly stressful situation for the rescuing medic, demanding prompt intervention. The effective stopping of a hemorrhage significantly reduces the risk of death for victims. The purpose of this study is to evaluate the students' chosen methods and the effectiveness of their actions during a simulated hemorrhage situation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!