U.S. Military use of tourniquets from 2001 to 2010.

Abstract

OBJECTIVE:

This study was conducted to associate tourniquet use and survival in casualty care over a decade of war in order to provide evidence to emergency medical personnel for the implementation and efficacy of tourniquet use in a large trauma system.

METHODS:

This survey is a retrospective review of data extracted from a trauma registry. The decade (2001-2010) outcome trend analysis of tourniquet use in the current wars was made in order to associate tourniquet use and survival in an observational cohort design.

RESULTS:

Of 4,297 casualties with extremity trauma in the total study, 30% (1,272/4,297) had tourniquet use and 70% (3,025/4,297) did not. For all 4,297 casualties, the proportion of casualties with severe or critical extremity Abbreviated Injury Scales (AIS) increased during the years surveyed (p < 0.0001); the mean annual Injury Severity Score (ISS) rose from 13 to 21. Tourniquet use increased during the decade by almost tenfold from 4 to nearly 40% (p < 0.0001). Survival for casualties with isolated extremity injury varied by injury severity; the survival rate for AIS 3 (serious) was 98%, the rate for AIS 4 (severe) was 76%, and the rate for AIS 5 (critical) was 0%. Survival rates increased for casualties with injuries amenable to tourniquets but decreased for extremity injuries too proximal for tourniquets.

CONCLUSIONS:

Average injury severity increased during the decade of war for casualties with extremity injury. Both tourniquet use rates and casualty survival rates rose when injuries were amenable to tourniquets.

• Authors: John F Kragh Jr, Michael A Dubick, James K Aden, Anne L McKeague, Todd E Rasmussen, David G Baer, Lorne H Blackbourne
• Journal: Prehospital emergency care (Prehosp Emerg Care) 2015 Apr-Jun Vol. 19 Issue 2 Pg. 184-90 ISSN: 1545-0066 [Electronic] England
• PMID: 25420089 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Extremities (injuries)
• Hemorrhage (mortality, therapy)
• Humans
• Injury Severity Score
• Military Medicine
• Registries
• Retrospective Studies
• Surveys and Questionnaires
• Survival Rate
• Tourniquets (statistics & numerical data)
• United States
• Warfare
• Wounds and Injuries (mortality, therapy)