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A multi-institutional analysis of prehospital tourniquet use
A multi-institutional analysis of prehospital tourniquet use
- Source :
- Journal of Trauma and Acute Care Surgery. 79:10-14
- Publication Year :
- 2015
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2015.
-
Abstract
- Recent military studies demonstrated an association between prehospital tourniquet use and increased survival. The benefits of this prehospital intervention in a civilian population remain unclear. The aims of our study were to evaluate tourniquet use in the civilian population and to compare outcomes to previously published military experience. We hypothesized that incorporation of tourniquet use in the civilian population will result in an overall improvement in mortality.This is a preliminary multi-institutional retrospective analysis of prehospital tourniquet (MIA-T) use of patients admitted to nine urban Level 1 trauma centers from January 2010 to December 2013. Patient demographics and mortality from a previous military experience by Kragh et al. (Ann Surg. 2009;249:1-7) were used for comparison. Patients younger than 18 years or with nontraumatic bleeding requiring tourniquet application were excluded. Data were analyzed using a two-tailed unpaired Student's t test with p0.05 as significant.A total of 197 patients were included. Tourniquets were applied effectively in 175 (88.8%) of 197 patients. The average Injury Severity Score (ISS) for MIA-T versus military was 11 ± 12.5 versus 14 ± 10.5, respectively (p = 0.02). The overall mortality and limb amputation rates for the MIA-T group were significantly lower than previously seen in the military population at 6 (3.0%) of 197 versus 22 (11.3%) of 194 (p = 0.002) and 37 (18.8%) of 197 versus 97 (41.8%) of 232 (p = 0.0001), respectively.Our study is the largest evaluation of prehospital tourniquet use in a civilian population to date. We found that tourniquets were applied safely and effectively in the civilian population. Adaptation of this prehospital intervention may convey a survival benefit in the civilian population.Epidemiologic study, level V.
- Subjects :
- Adult
Male
Emergency Medical Services
genetic structures
Treatment outcome
Wounds, Penetrating
Critical Care and Intensive Care Medicine
Injury Severity Score
Emergency medical services
Humans
Medicine
Institutional analysis
Retrospective Studies
Tourniquet
business.industry
Retrospective cohort study
Tourniquets
equipment and supplies
Civilian population
medicine.disease
humanities
body regions
Treatment Outcome
surgical procedures, operative
Multicenter study
Wounds and Injuries
Female
Surgery
Medical emergency
business
Subjects
Details
- ISSN :
- 21630755
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- Journal of Trauma and Acute Care Surgery
- Accession number :
- edsair.doi.dedup.....e2ea4a282883549209ed1af6a19d9ebb
- Full Text :
- https://doi.org/10.1097/ta.0000000000000689