BACKGROUND: In a previous study conducted at a combat support hospital in Iraq, we reported the major lifesaving benefits of emergency tourniquets to stop bleeding in major limb trauma. Morbidity associated with tourniquet use was minor. STUDY OBJECTIVES: The objective of this study is to further analyze emergency tourniquet use in combat casualty care. DESIGN AND SETTING: This report is a continuation of our previous study of tourniquet use in casualties admitted to a combat support hospital (NCT00517166 at www.ClinicalTrials.gov). METHODS: After verifying comparable methodologies for the first study and the current study, we compared patient results for these two time periods and then pooled data to analyze outcomes with a larger sample size. RESULTS: The total study population was 499 (232 in the previous study and 267 in the current study). In all, 862 tourniquets were applied on 651 limbs. Survival was 87% for both study periods. Morbidity rates for palsies at the level of the tourniquet were 1.7% for study 1 and 1.5% for study 2; major limb shortening was 0.4% for both. Survival was associated with prehospital application (89% vs. 78% hospital, p < 0.01) and application before the onset of shock (96% vs. 4% after). CONCLUSIONS: This study shows consistent lifesaving benefits and low risk of emergency tourniquets to stop bleeding in major limb trauma. Published by Elsevier Inc.
BACKGROUND: In a previous study conducted at a combat support hospital in Iraq, we reported the major lifesaving benefits of emergency tourniquets to stop bleeding in major limb trauma. Morbidity associated with tourniquet use was minor. STUDY OBJECTIVES: The objective of this study is to further analyze emergency tourniquet use in combat casualty care. DESIGN AND SETTING: This report is a continuation of our previous study of tourniquet use in casualties admitted to a combat support hospital (NCT00517166 at www.ClinicalTrials.gov). METHODS: After verifying comparable methodologies for the first study and the current study, we compared patient results for these two time periods and then pooled data to analyze outcomes with a larger sample size. RESULTS: The total study population was 499 (232 in the previous study and 267 in the current study). In all, 862 tourniquets were applied on 651 limbs. Survival was 87% for both study periods. Morbidity rates for palsies at the level of the tourniquet were 1.7% for study 1 and 1.5% for study 2; major limb shortening was 0.4% for both. Survival was associated with prehospital application (89% vs. 78% hospital, p < 0.01) and application before the onset of shock (96% vs. 4% after). CONCLUSIONS: This study shows consistent lifesaving benefits and low risk of emergency tourniquets to stop bleeding in major limb trauma. Published by Elsevier Inc.
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Authors: Michelle H Scerbo; Jacob P Mumm; Keith Gates; Joseph D Love; Charles E Wade; John B Holcomb; Bryan A Cotton Journal: Prehosp Emerg Care Date: 2016-05-31 Impact factor: 3.077
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