Increased tourniquet use has saved lives: Study
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Uncontrolled bleeding continues to be one of the most common causes of preventable death from a traumatic injury. However, patient survival from such injuries has improved in Los Angeles County due to increased use of tourniquets to help stop severe bleeding before a patient arrives at a hospital. Findings appear in a Journal of the American College of Surgeons.

This is a retrospective cohort study using a database maintained by the Los Angeles County Emergency Medical Services Agency. Researchers included patients who sustained extremity vascular injuries between October 2015 and July 2019. Patients were divided into two study groups: prehospital tourniquet (PHTQ) and no-tourniquet (no-PHTQ) groups. Their primary outcome was in-hospital mortality. The secondary outcomes included 4- and 24-hour transfusion requirements, and delayed amputation.

A total of 944 patients met the inclusion criteria. Of those, 97 patients had prehospital tourniquets placed. The rate of tourniquet use increased linearly throughout the study period.

--In multivariable analysis, prehospital tourniquet use was significantly associated with improved mortality.

--Similarly, transfusion requirements were significantly lower within 4 hours and 24 hours.

--There was no significant difference in delayed amputation rates.

The results suggest that the use of prehospital tourniquets for extremity vascular injuries is associated with improved patient survival and decreased blood transfusion requirements, without an increase in delayed amputations.

Source: https://doi.org/10.1016/j.jamcollsurg.2021.03.023
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