Minor Morbidity With Emergency Tourniquet Use to Stop Bleeding in Severe Limb Trauma: Research, History, and Reconciling Advocates and Abolitionists

Kragh, John F; O'Neill, Michelle L; Walters, James; Jones, John A.; Baer, David G.; Gershman, Leigh K; Wade, Charles E.; Holcomb, John B.

doi:10.7205/milmed-d-10-00417

Cited by 89 publications

(54 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4] Unfortunately many combat-type injuries, such as those seen during the Boston Marathon bombing, occur in the United States. 5 To address this, The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events produced recommendations known as the Hartford Consensus I and II.…”

mentioning

confidence: 99%

Just‐in‐Time to Save Lives: A Pilot Study of Layperson Tourniquet Application

Goolsby

Branting

Chen

et al. 2015

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objective was to determine whether just-in-time (JiT) instructions increase successful tourniquet application by laypersons.Methods: This was a randomized pilot study conducted in August 2014. The study occurred at the Uniformed Services University campus in Bethesda, Maryland. A total of 194 volunteers without prior military service or medical training completed the study. The participant stood in front of a waist-down mannequin that had an exposed leg. An observer read a scenario card aloud that described a mass casualty event. The observer then asked the participant to apply a Combat Application Tourniquet (C-A-T) to the mannequin. Test participants received a 4 9 6-inch card, with JiT instructions, in addition to their C-A-T; controls received no instructions. Participants were randomized in a 3:1 ratio of instructions to no instructions. The study's primary outcome was the proportion of successfully applied tourniquets by participants receiving JiT instructions compared to participants not receiving instructions. Secondary outcomes included the time for successful tourniquet placement, reasons for failed tourniquet application, and participants' self-reported willingness and comfort using tourniquets in real-life settings.Results: Just-in-time instructions more than doubled successful tourniquet placement. Participants supplied with JiT instructions placed a tourniquet successfully 44.14% of the time, compared to 20.41% of the time for controls without instructions (risk ratio = 2.16; 95% confidence interval = 1.21 to 3.87; p = 0.003).

show abstract

mentioning

confidence: 99%

Just‐in‐Time to Save Lives: A Pilot Study of Layperson Tourniquet Application

Goolsby

Branting

Chen

et al. 2015

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…86 In a large study of 862 tourniquet applications, no limbs were lost as a result of the tourniquet. 88 The usefulness for civilian use (Box 10) is still being defined, but enthusiasm for tourniquets has been renewed. 1 …”

Section: Damage Control Strategies In Vascular Extremity Traumamentioning

confidence: 99%

Modern Advances in Vascular Trauma

Callcut

Mell

2013

Surgical Clinics of North America

View full text Add to dashboard Cite

“…Interestingly, their article mentions that some 13 patients had paradoxical bleeding (increased, not decreased bleeding) because of the phenomenon of the inadequately deployed, or "venous" tourniquet. 15 The present doctrine used by the U.S. military is that every soldier in the field has a tourniquet and knows how to use it. The present tourniquet, deployed with our war fighters, has been modified and improved.…”

Section: Modern Use Of Tourniquetsmentioning

confidence: 99%