Warning: Tourniquets Risk Frostbite in Cold Weather

Area of Science:

• Emergency Medicine
• Environmental Health
• Trauma Surgery

Background:

• Future conflicts may occur in extreme cold, increasing the relevance of frostbite risk with tourniquet use.
• Historically, tourniquet use in cold has been associated with severe frostbite, potentially leading to amputation.

Purpose of the Study:

• To investigate the association between first-aid tourniquet application and frostbite risk.
• To review existing information on tourniquet use and cold injury.

Main Methods:

• Literature review of historical cases, animal experiments, and human studies.
• Analysis of physiological responses to cold exposure and tourniquet application.

Main Results:

• Tourniquet use was found to increase frostbite development in animal models.
• Human studies support an association between tourniquet use and frostbite.
• Reduced blood flow from tourniquets may exacerbate cold injury by limiting tissue perfusion and preventing cold-induced vasodilation.

Conclusions:

• An association exists between tourniquet use and frostbite, though not direct cause and effect.
• Tourniquet use can accelerate limb cooling in cold environments, heightening frostbite risk.
• Medical providers are cautioned about the increased risk of frostbite when using tourniquets in temperatures below 0°C (32°F).