Performance improvement in emergency tourniquet use during the Baghdad surge

Transfusion for Shock in US Military War Casualties With and Without Tourniquet Use

“…Such a high survival rate and a decreased miss rate have been shown in a 2006 to 2007 survey of tourniquet use in Baghdad, Iraq, that was published in 2013. 9 Individuals most in need of tourniquets in Baghdad were casualties exsanguinating out of hospital from an isolated, compressible extremity wound. 4,5 During the course of the war, the annual rate of US casualties dying out of hospital from extremity exsanguination without tourniquets decreased 6.7-fold at widespread tourniquet fielding.…”

Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care—Part 1: Tourniquets

“…12 Today, although tourniquets have been shown to control bleeding effectively on the battlefield [13][14][15][16][17] and during surgery and have been used by paramedics in a civilian setting without complications, 18 there are no studies on first-aid providers (laypersons) controlling bleeding with tourniquets. However, athletic trainers are not laypersons and with proper training can properly apply a tourniquet in an emergency.…”

“…In 2013 Kragh et al 17 analyzed emergency tourniquet use in combat casualty care and documented the impact of processimprovement efforts over time on tourniquet success rates. Prospective data were collected and analyzed over three separate time periods in a military hospital that supported combat and related security work in Iraq, where casualties, including civilians, were admitted directly or transferred from forward surgical teams.…”

“…The three additional studies demonstrated consistent life-saving benefits and a low risk of emergency tourniquets to stop bleeding in major limb trauma by both medical and nonmedical personnel. 14,15,17 Beekley et al 13 examined the effects of prehospital tourniquet use on the hemorrhage control and outcomes during Operation Iraqi Freedom. A retrospective analysis of the 31st Combat Support Hospital for 1 year during Operation Iraqi Freedom found that of the 3444 total admissions, 165 patients met inclusion criteria.…”

Prolonged prehospital tourniquet placement associated with severe complications: a case report

“…[1][2][3] Due to the potential for significant complications (including clots, myonecrosis, pain, palsy, abscess, blisters, contusions, abrasions, renal failure, compartment syndrome, and amputation) 4 and the paucity of evidence of its role in the non-military context, controversy persists regarding tourniquet use. We describe a civilian case in which improvised tourniquets were applied to an extremity for 17 hours following a penetrating lower limb injury in a remote area of Quebec.…”