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    Tourniquets in the treatment of prehospital haemorrhage

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    Author
    Bond, Reiss
    Keyword
    Emergency Medical Services
    Tourniquet
    Haemorrhage
    Trauma
    Pre-hospital Care
    Journal title
    Journal of Paramedic Practice
    
    Metadata
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    URI
    http://hdl.handle.net/20.500.12417/132
    DOI
    10.12968/jpar.2018.10.11.477
    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.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2018.10.11.477
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