Tourniquets in the treatment of prehospital haemorrhage
Bond, Reiss
Bond, Reiss
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Abstract
Abstract published with permission.
Background: During recent conflicts in Iraq and Afghanistan, tourniquets were
a useful tool in the management of non-compressible prehospital catastrophic
haemorrhage. Recommendations for use within the civilian setting were then
made. However, civilian research supporting this change in practice is limited.
Aims: The aim of the research is to evaluate the utility of prehospital tourniquet
application through description of the complications associated with use, as
well as identification of mortality following prehospital application. Methods:
A literature search was completed using PubMed and Embase for research
studies on prehospital tourniquet use in extremity trauma. Study relevance
was confirmed via their abstracts and final selection was made through
reviewing the full publication. Data were extracted on mortality, complications,
indication for use, effective application and application duration of tourniquet
use. This was tabulated, and a descriptive analysis performed. Results: The
research reported a mortality range of 3–14% with an associated complication
rate of 2.1–32.4%. The effectiveness of prehospital application was in the
88.8–98.7% range, with tourniquet application durations of 48–103.2 minutes.
Conclusions: The tourniquet should continue to be available to UK paramedics
for the management of prehospital non-compressible catastrophic haemorrhage.
Application is likely to provide a mortality benefit with limited morbidity and
associated complications.