Civilian prehospital tourniquet use saves lives, limbs

Editor's Note

Though still underused, this study found civilian prehospital tourniquet application tied to a six-fold reduction in mortality in peripheral vascular injuries.

The Texas Tourniquet Study Group analyzed 1,026 patients with vascular injuries of the arms or legs admitted to 11 Level I trauma centers in Texas from 2011 to 2016.

A prehospital tourniquet was used in 181 (17.6%) patients. Those who received a tourniquet had significantly lower mortality rates than those who did not (2.9% vs 7.9%). Traumatic amputations occurred in 98 patients (35.7%), and mortality was 5.2% in the nontourniquet group versus 3.9% in the tourniquet group.

Multivariate analysis found the use of tourniquets was independently associated with survival. Delayed amputation rates were similar for both groups.

More aggressive prehospital application of tourniquets in trauma patients with extremity hemorrhage and traumatic amputation is warranted, the authors say.