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Tourniquet Use in the Prehospital Setting.

Elizabeth M McCarthy1, Kevin Burns2, Kevin M Schuster2

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Prehospital tourniquet use is highly effective for controlling severe bleeding, with a 96% success rate and a low complication rate. This study details their application in a regional EMS system, highlighting safety and efficacy in civilian emergencies.

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Area of Science:

  • Emergency Medicine
  • Trauma Care
  • Hemorrhage Control

Background:

  • Tourniquets are critical for life-saving hemorrhage control, with established safety and effectiveness in military combat settings.
  • Civilian mass casualty events underscore the need for correct tourniquet application in emergencies.
  • Limited research exists on prehospital tourniquet use in civilian settings compared to military applications.

Purpose of the Study:

  • To describe the prehospital application of tourniquets within a regional Emergency Medical Services (EMS) system.
  • To analyze the outcomes and complications associated with prehospital tourniquet use in a civilian trauma center's service area.

Main Methods:

  • Retrospective review of all documented prehospital tourniquet uses from 2015 to 2020.
  • Data extracted from EMS, emergency department, and inpatient records.
  • Primary outcomes included duration of application, hemorrhage control success, and complications; secondary outcomes detailed timing, transport, injury specifics, and personnel involved.

Main Results:

  • Of 185 tourniquets applied to 182 patients, hemorrhage control was achieved in 96% of cases.
  • Median tourniquet duration was 43 minutes; serious complications occurred in 7.7% of cases.
  • Common injury mechanisms included gunshot wounds and motorcycle accidents; EMS clinicians and police were frequent applicators.

Conclusions:

  • Prehospital tourniquet application demonstrates a high success rate for hemorrhage control.
  • Tourniquet use in civilian prehospital settings is associated with a low incidence of complications.
  • Findings support the continued and correct use of tourniquets for life-threatening extremity hemorrhage.