The Efficacy of Novel Commercial Tourniquet Designs for Extremity Hemorrhage Control: Implications for Spontaneous Responder Every Day Carry

Ellis, Joshua S.; Morrow, Melissa M.; Belau, Alec; Sztajnkrycer, Luke; Wood, Jeffrey N.; Kummer, Tobias; Sztajnkrycer, Matthew D.

doi:10.1017/s1049023x2000045x

Cited by 3 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this sense, it is recommended that it be re-evaluated every 30 minutes to ensure that bleeding or possible complications have been properly controlled to optimise tourniquet use (Malo et al, 2015). There is a 2-hour safe time window for the release of the tourniquet, although there are documented cases that kept the tourniquet in place for up to 6 hours (Callaway et al, 2015;Drew, Bird, et al, 2015;Ellis et al, 2020;R. B.…”

Section: Discussionmentioning

confidence: 99%

Tourniquets as a haemorrhage control measure in military and civilian care settings: An integrative review

Román

Rodriguez-Alvarez

Bertini-Perez

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives: The aim of review was to describe and synthesise the evidence on the use of tourniquets to control haemorrhages, summarising both civilian and military use.Background: Trauma-related haemorrhage constitute one of the most preventable deaths among injured patients, particularly in multi-casualty incidents and disasters. In this context, safe instruments such as tourniquets are essential to help healthcare professionals to minimise loss of life and maximise patient recovery. Design and Methods: An integrative review was conducted in Medline, Nursing & Allied Health Premium, and Health & Medical Collection, using published data until March 2021 and following the PRISMA guidelines. Results: A total of 25 articles were included. Evidence has been synthesised to understand the use of different types of tourniquets, environment of application, indication for their placement and potential complications associated with tourniquet placement. Conclusions: Commercial tourniquets such as Combat Application Tourniquet orEmergency Tourniquet models are a valuable and safe instrument for haemorrhage control in both military and civilian out-of-hospital care settings. Nurses, as part of emergency teams, and other professionals should be aware that there is a possibility of adverse complications, but they are directly proportional to the time of tourniquet placement and generally temporary. In addition, national and international guidelines ensure the need for all civilian emergency services to be equipped with these devices, as well as for the training of healthcare professionals and first responders in their use.Relevance to clinical practice: Despite the lack of complications in the use of tourniquets in these cases, their use has been a matter of debate for decades. In this sense, this review 2 yields up-to-date guidelines in the use of tourniquets, their recommendations and their significance among professionals to manage complicated situations.

show abstract

Section: Discussionmentioning

confidence: 99%

Tourniquets as a haemorrhage control measure in military and civilian care settings: An integrative review

Román

Rodriguez-Alvarez

Bertini-Perez

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…The apparent upper limit on sustained competency without ongoing remedial training calls into question the windlass design itself. A recent study used nine emergency medicine residents to test three nonwindlass designs against the criterion standard windlass, but no design outperformed the windlass in successful application or time to apply 31 . A more intuitive design that relies less on mechanical advantage may prove to be more efficacious in real-life scenarios.…”

Section: Discussionmentioning

confidence: 99%

The tight rope act: A multicenter regional experience of tourniquets in acute trauma resuscitation

Tatebe

Schlanser

Hampton

et al. 2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

BACKGROUND:As tourniquets have become more prevalent, device use has been questioned. This study sought to characterize the incidence, indication, and efficacy of tourniquet placement in acute trauma resuscitation. METHODS:Nine regional level 1 trauma centers prospectively enrolled for 12 months adult patients (18 years or older) who had a tourniquet placed. Age, sex, mechanism, tourniquet type, indication, applying personnel, location placed, level of occlusion, and degree of hemostasis were collected. Major vascular injury, imaging and operations performed, and outcomes were assessed. Analyses were performed with significance at p < 0.05. RESULTS:A total of 216 tourniquet applications were reported on 209 patients. There were significantly more male patients (183 [88%]) and penetrating injuries (186 [89%]) with gunshots being most common (127 [61%]). Commercial tourniquets were most often used (205 [95%]). Ninety-two percent were placed in the prehospital setting (by fire/paramedics, 56%; police, 33%; bystanders, 2%).The most common indications were pooling (47%) and pulsatile (32%) hemorrhage. Only 2% were for amputation. The most frequent location was high proximal extremity (70%). Four percent were placed over the wound, and 0.5% were distal to the wound. Only 61% of applications were arterial occlusive. Median application time was 30 minutes (interquartile range, 20-40 minutes).Imaging was performed in 54% of patients. Overall, 36% had a named arterial injury. Tourniquet application failed to achieve hemostasis in 22% of patients with a named vascular injury. There was no difference in hemostasis between those with and without vascular injury ( p = 0.12) or between who placed the tourniquet ( p = 0.07). Seventy patients (34%) required vascular operations. Thirty-four percent of patients were discharged home without admission. CONCLUSION:Discerning which injuries require tourniquets over pressure dressings remains elusive. Trained responders had high rates of superfluous and inadequate deployments. As tourniquets continue to be disseminated, emphasis should be placed on improving education, device development, and quality control.

show abstract

Design of a system to detect the force applied by tourniquets in a manikin’s limb

Viola¹,

Lagazzi

Ballardini³

et al. 2021

2021 43rd Annual International Conference of the IEEE Engineering in Medicine &Amp; Biology Society (EMBC)

View full text Add to dashboard Cite

The Efficacy of Novel Commercial Tourniquet Designs for Extremity Hemorrhage Control: Implications for Spontaneous Responder Every Day Carry

Cited by 3 publications

References 27 publications

Tourniquets as a haemorrhage control measure in military and civilian care settings: An integrative review

Tourniquets as a haemorrhage control measure in military and civilian care settings: An integrative review

The tight rope act: A multicenter regional experience of tourniquets in acute trauma resuscitation

Design of a system to detect the force applied by tourniquets in a manikin’s limb

Contact Info

Product

Resources

About