Tourniquet Use in the Prehospital Setting

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.