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Prehospital tourniquet

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https://www.readbyqxmd.com/read/27689248/trends-and-predictors-of-limb-tourniquet-use-by-civilian-emergency-medical-services-in-the-united-states
#1
Mazen J El Sayed, Hani Tamim, Aurelie Mailhac, N Clay Mann
BACKGROUND: Tourniquet use by Emergency Medical Services (EMS) can be life saving for severely injured patients. The adoption of this intervention is not well described in civilian settings. This study describes patterns and trends of tourniquet use by civilian EMS and identifies predictors of such use. METHODS: A retrospective study of four consecutive releases of the U.S. National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-14) was conducted...
September 30, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27623805/prehospital-control-of-life-threatening-truncal-and-junctional-haemorrhage-is%C3%A2-the-ultimate-challenge-in-optimizing-trauma-care-a-review-of-treatment-options-and-their-applicability-in-the-civilian-trauma-setting
#2
REVIEW
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
September 13, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27563467/trauma-simulation-training-increases-confidence-levels-in-prehospital-personnel-performing-life-saving-interventions-in-trauma-patients
#3
Christine M Van Dillen, Matthew R Tice, Archita D Patel, David A Meurer, Joseph A Tyndall, Marie Carmelle Elie, Jonathan J Shuster
Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training. Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27450599/preliminary-comparison-of-pneumatic-models-of-tourniquet-for-prehospital-control-of-limb-bleeding-in-a-manikin-model
#4
Rudy Gibson, James K Aden, Michael A Dubick, John F Kragh
BACKGROUND: Emergency tourniquet use has been associated with hemorrhage control and improved survival during the wars since 2001, but little is known of the differential performance of pneumatic tourniquet models. The purpose of this study was to compare the performance of three models of pneumatic tourniquets in a laboratory setting to aid a possible decision to field test suitable models for medic preference. METHODS: A laboratory experiment was designed to test the effectiveness of tourniquets on a manikin thigh...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27257704/a-multi-institutional-study-of-hemostatic-gauze-and-tourniquets-in-rural-civilian-trauma
#5
Jennifer Leonard, John Zietlow, David Morris, Kathleen Berns, Steven Eyer, Kurt Martinson, Donald Jenkins, Scott Zietlow
BACKGROUND: Life-threatening hemorrhage is a leading cause of preventable mortality in trauma patients. Since publication of the Hartford Consensus statement, there has been intense interest in civilian use of commercial hemostatic gauze and tourniquets. Although the military has studied their use on soldiers with wartime injuries, there are limited data on patient outcomes following civilian prehospital use and no data on the use in rural trauma. METHODS: We performed a multi-institutional retrospective analysis of clinical outcomes following prehospital use of QuikClot combat gauze (QC) and combat application tourniquets (CATs) from 2009 to 2014...
September 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27245978/safety-and-appropriateness-of-tourniquets-in-105-civilians
#6
Michelle H Scerbo, Jacob P Mumm, Keith Gates, Joseph D Love, Charles E Wade, John B Holcomb, Bryan A Cotton
BACKGROUND: The United States military considers tourniquets to be effective for controlling bleeding from major limb trauma. The purpose of this study was to assess whether tourniquets are safely applied to the appropriate civilian patient with major limb trauma of any etiology. METHODS: Following IRB approval, patients arriving to a level-1 trauma center between October 2008 and May 2013 with a prehospital (PH) or emergency department (ED) tourniquet were reviewed...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27238996/vascular-injuries-in-combat-specific-soldiers-during-operation-iraqi-freedom-and-operation-enduring-freedom
#7
John C Dunn, Nicholas Kusnezov, Andrew J Schoenfeld, Justin D Orr, Patrick J Cook, Philip J Belmont
BACKGROUND: This study sought to identify vascular injury patterns among combat-specific cavalry scout personnel within the Iraq and Afghanistan Wars. METHODS: The Armed Forces Medical Examiner System and Joint Theater Trauma Registry were queried for all injuries with the cavalry scout designation from 2003 to 2011, including those both wounded in action (WIA) and killed in action (KIA). A description of vascular injury, combat causality care statistics, mechanism of injury, and demographic data were recorded...
August 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27215863/battlefield-tourniquets-lessons-learned-in-moving-current-care-toward-best-care-in-an-army-medical-department-at-war
#8
John F Kragh, Michael A Dubick
Bleeding prevention and control by tourniquet use by out-of-hospital caregivers is a major breakthrough in military medicine of current wars. The present review documents developments in tourniquet practices since 2001 among the US military services for aid in improving doctrine, policy, and especially care in wars to come. Tourniquets are an adjunct for resuscitation in self-care and buddy aid and today are issued to all military servicepersons who deploy into a combat zone. In the US Army, virtually every Soldier is trained in first aid tourniquet use; since 2009 they are instructed early and often to use them early and often...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27100757/surgical-adjuncts-to-noncompressible-torso-hemorrhage-as-tools-for-patient-blood-management
#9
Joseph F Rappold, Grant V Bochicchio
Despite the tremendous advances and successes in the care of combat casualties over the past 15 years of war, noncompressible torso hemorrhage (NCTH) remains the most likely source of potentially preventable death (approx. 25%) on the battlefield. This is also likely true for civilian victims of blunt and penetrating trauma. Various devices and therapeutic interventions have been, and are being, developed in an attempt to reduce morbidity and mortality for patients with NCTH. Examples include the use of prehospital blood and blood products, tranexamic acid, specially designed tourniquets for junctional hemorrhage control, retrograde endovascular balloon occlusion of the aorta, intracavity foam, expandable hemostatic sponges, and intravascular nanoparticles to suspended animation...
April 2016: Transfusion
https://www.readbyqxmd.com/read/27045492/testing-of-junctional-tourniquets-by-medics-of-the-israeli-defense-force-in-control-of-simulated-groin-hemorrhage
#10
COMPARATIVE STUDY
Jacob Chen, Avi Benov, Roy Nadler, Geva Landau, Alex Sorkin, James K Aden, John F Kragh, Elon Glassberg
BACKGROUND: Junctional hemorrhage is a common cause of battlefield death but little is known about testing of junctional tourniquet models by medics. The purpose of the testing described herein is to assess military experience in junctional tourniquet use in simulated prehospital care. METHODS: Fourteen medics were to use the following four junctional tourniquets: Combat Ready Clamp (CRoC), Abdominal Aortic Junctional Tourniquet (AAJT), Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT)...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/26974324/does-it-matter-who-places-the-intravenous-an-inter-professional-comparison-of-prehospital-intravenous-access-difficulties-between-physicians-and-paramedics
#11
Johannes Prottengeier, Jan-Niklas Maier, Christine Gall, Sebastian Heinrich, Joachim Schmidt, Torsten Birkholz
OBJECTIVES: Depending on the specific national emergency medical systems, venous cannulations may be performed by physicians, paramedics or both alike. Difficulties in the establishment of vascular access can lead to delayed treatment and transport. Our study investigates possible inter-professional differences in the difficulties of prehospital venous cannulation. METHODS: Paramedics were interviewed for their personal attitudes towards and experiences in venous access...
March 11, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26885995/contemporary-outcomes-of-lower-extremity-vascular-repairs-extending-below-the-knee-a-multicenter-retrospective-study
#12
Gerald Fortuna, Joseph J DuBose, Ranan Mendelsberg, Kenji Inaba, Ansab Haider, Bellal Joseph, David Skarupa, Matthew J Selleck, Thomas A OʼCallaghan, Kristofer Charlton-Ouw
OBJECTIVES: To determine the outcomes of vascular injury interventions extending below the knee. METHODS: Vascular injury repairs extending below the knee from January 2008 to December 2014 were collected from six American College of Surgeons Level I trauma centers. Demographics, management, and outcomes were collected and analyzed. RESULTS: A total of 194 vascular injuries were identified. The mean age was 33.7 years, with 88.1% male, and 71...
July 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26680137/prehospital-interventions-in-severely-injured-pediatric-patients-rethinking-the-abcs
#13
Kyle K Sokol, George E Black, Kenneth S Azarow, William Long, Matthew J Martin, Matthew J Eckert
BACKGROUND: The current conflict in Afghanistan has resulted in a high volume of significantly injured pediatric patients. The austere environment has demanded emphasis on prehospital interventions (PHIs) to sustain casualties during transport. METHODS: The Department of Defense Trauma Registry was queried for all pediatric patients (≤18 years) treated at Camp Bastion from 2004 to 2012. PHIs were grouped by Advanced Trauma Life Support categories into (1) airway (A)--intubation or surgical airway; 2) breathing (B)--chest tube or needle thoracostomy; and 3) circulation (C)--tourniquet or hemostatic dressing...
December 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26630705/use-of-a-tourniquet-by-life-star-air-medical-crew-a-case-report
#14
Lenworth M Jacobs, Karyl J Burns, Heather Standish Priest, William Muskett
For many years tourniquets were perceived as dangerous due to the belief that they led to loss of limb because of ischemia. Their use in civilian and military environments was discouraged. Emergency medical responders were not taught about tourniquets and commercial tourniquets were not available. However, research by the United States military during the wars in Iraq and Afghanistan has demonstrated that tourniquets are safe life-saving devices. As a consequence, they have been widely deployed in combat situations and there are now calls for the use of tourniquets in the civilian prehospital setting...
October 2015: Connecticut Medicine
https://www.readbyqxmd.com/read/26406432/prehospital-use-of-hemostatic-dressings-by-the-israel-defense-forces-medical-corps-a-case-series-of-122-patients
#15
Avi Shina, Ari M Lipsky, Roy Nadler, Moran Levi, Avi Benov, Yuval Ran, Avraham Yitzhak, Elon Glassberg
BACKGROUND: Hemostatic dressings are advanced topical dressings designed to control hemorrhage by enhancing clot formation. These dressings may be effective when used on injuries sustained in junctional zones. The Israeli Defense Forces Medical Corps (IDF-MC) chose to equip its medical personnel with the QuikClot Combat Gauze. There is a paucity of data describing clinical use and results of hemostatic dressing especially at the point of injury. The purpose of this article was to report the IDF-MC experience with prehospital use of the QuikClot Combat Gauze in junctional zones in a case series retrieved from the IDF Trauma Registry...
October 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26351975/hemostatic-dressings-in-civil-prehospital-practice-30-uses-of-quikclot-combat-gauze
#16
Stéphane Travers, Hugues Lefort, Eric Ramdani, Sabine Lemoine, Daniel Jost, Michel Bignand, Jean-Pierre Tourtier
To report the use and describe the interest of hemostatic dressings in a civilian setting, we provided medical prehospital teams with QuikClot Combat Gauze (QCG) and asked physicians to complete a specific questionnaire after each use. Thirty uses were prospectively reported. The wounds were mostly caused by cold steel (n=15) and were primarily cervicocephalic (n=16), with 19/30 active arterial bleedings. For 26/30 uses, hemostatic dressing was justified by the inefficiency of other hemostasis techniques. Those 30 applications were associated with 22 complete cessations of bleeding, six decreases of bleeding, and ineffectiveness in two cases...
October 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26218691/tourniquet-use-for-civilian-extremity-trauma
#17
Kenji Inaba, Stefano Siboni, Shelby Resnick, Jay Zhu, Monica Darlene Wong, Tobias Haltmeier, Elizabeth Benjamin, Demetrios Demetriades
BACKGROUND: Unlike in the military setting, where the use of tourniquets has been well established, in the civilian sector their use has been far less uniform. The purpose of this study was to examine the outcomes associated with the use of tourniquets for civilian extremity trauma. STUDY DESIGN: Adult (≥18 years) patients admitted to our institution with an extremity injury requiring tourniquet application from January 2007 to June 2014 were retrospectively reviewed...
August 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26218690/decreased-mortality-after-prehospital-interventions-in-severely-injured-trauma-patients
#18
Jonathan P Meizoso, Evan J Valle, Casey J Allen, Juliet J Ray, Jassin M Jouria, Laura F Teisch, David V Shatz, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: We test the hypothesis that prehospital interventions (PHIs) performed by skilled emergency medical service providers during ground or air transport adversely affect outcome in severely injured trauma patients. METHODS: Consecutive trauma activations (March 2012 to June 2013) transported from the scene by air or ground emergency medical service providers were reviewed. PHI was defined as intubation, needle decompression, tourniquet, cricothyroidotomy, or advanced cardiac life support...
August 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26210224/military-to-civilian-translation-of-battlefield-innovations-in-operative-trauma-care
#19
Adil H Haider, Lydia C Piper, Cheryl K Zogg, Eric B Schneider, Jean A Orman, Frank K Butler, Robert T Gerhardt, Elliott R Haut, Jacques P Mather, Ellen J MacKenzie, Diane A Schwartz, David W Geyer, Joseph J DuBose, Todd E Rasmussen, Lorne H Blackbourne
BACKGROUND: Historic improvements in operative trauma care have been driven by war. It is unknown whether recent battlefield innovations stemming from conflicts in Iraq/Afghanistan will follow a similar trend. The objective of this study was to survey trauma medical directors (TMDs) at level 1-3 trauma centers across the United States and gauge the extent to which battlefield innovations have shaped civilian practice in 4 key domains of trauma care. METHODS: Domains were determined by the use of a modified Delphi method based on multiple consultations with an expert physician/surgeon panel: (1) damage control resuscitation (DCR), (2) tourniquet use, (3) use of hemostatic agents, and (4) prehospital interventions, including intraosseous catheter access and needle thoracostomy...
December 2015: Surgery
https://www.readbyqxmd.com/read/26134057/prolonged-prehospital-tourniquet-placement-associated-with-severe-complications-a-case-report
#20
Christian Malo, Bruno Bernardin, Joe Nemeth, Kosar Khwaja
No abstract text is available yet for this article.
July 2015: CJEM
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