U.S. Military Use of Tourniquets from 2001 to 2010
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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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 1,2724,297 had tourniquet use and 70 3,0254,297 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.
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