Prehospital tourniquet placement in extremity trauma

Background: Extremity tourniquets (ET) use has increased in trauma systems to manage traumatic hemorrhage. This study aims to evaluate prehospital ET placement. Methods: This is a retrospective review of a prospectively collected cohort of 211 adult patients who underwent prehospital ET placement over 3 1/2 years. Data regarding ET placement was analyzed regarding ET applier, reported indications, extremity appearance at arrival and outcomes. Results: A total of 211 patients had completed data sheets. Of these patients, 63.2% had no other intervention prior to ET placement. On arrival, nearly 1/3 of the patients had palpable pulses with ET in place and less than 1/2 had arterial bleeding upon ET release. Discussion/conclusions: This study shows that ET are frequently used as the initial intervention in the field. It is of paramount importance that we adapt our first responders training to teach wound assessment and appropriate steps in management of extremity hemorrhagic trauma.