Effect of prehospital tourniquets on resuscitation in extremity arterial trauma

Trauma Surgery & Acute Care Open
Allison G McNickleJohn J Fildes

Abstract

Timely tourniquet placement may limit ongoing hemorrhage and reduce the need for blood products. This study evaluates if prehospital tourniquet application altered the initial transfusion needs in arterial injuries when compared with a non-tourniquet control group. Extremity arterial injuries were queried from our level I trauma center registry from 2013 to 2017. The characteristics of the cohort with prehospital tourniquet placement (TQ+) were described in terms of tourniquet use, duration, and frequency over time. These cases were matched 1:1 by the artery injured, demographics, Injury Severity Score, and mechanism of injury to patients arriving without a tourniquet (TQ-). The primary outcome was transfusion within the first 24 hours, with secondary outcomes of morbidity (rhabdomyolysis, renal failure, compartment syndrome), amputation (initial vs. delayed), and length of stay. Statistical tests included t-test and χ2 for continuous and categorical variables, respectively, with p<0.05 considered as significant. Extremity arterial injuries occurred in 192 patients, with 69 (36%) having prehospital tourniquet placement for an average of 78 minutes. Tourniquet use increased over time from 9% (2013) to 62% (2017). TQ+ patients we...Continue Reading

References

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Dec 28, 2018·Trauma Surgery & Acute Care Open·Adam D LaytinRochelle A Dicker

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Citations

Jan 21, 2021·Revista do Colégio Brasileiro de Cirurgiões·Carlos YÁnez BenÍtezMarcelo Augusto Fontenelle Ribeiro Junior
Apr 26, 2021·Journal of the American College of Surgeons·Reynold HenryKenji Inaba
Jun 2, 2021·Anaesthesia Critical Care & Pain Medicine·Julien PottecherHervé Quintard
Mar 7, 2021·The Journal of Trauma and Acute Care Surgery·Sharven TaghaviDanielle Tatum

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Methods Mentioned

BETA
amputation
amputations

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