Research shows most potentially preventable traumatic fatalities are related to bleeding and a large portion of these deaths are the result of a limb injury.1 If medical providers are to improve penetrating trauma survival, the initial focus must be on hemorrhage control in the field. As the military’s successful treatment of life-threatening extremity hemorrhage by tourniquet placement became known, a push started to increase the routine use of tourniquets for extremity hemorrhage control in the civilian setting. Just as transitioning civilian trauma practices to the military setting required thoughtful evaluation, transitioning successful military trauma practices to the civilian setting should not be done without the assurance that they will be effective. A committee of medical experts evaluated Tactical Combat Casualty Care (TCCC) recommendations and ultimately created a civilian model for field trauma care called Tactical Emergency Casualty Care (TECC). TECC provided a civilian framework for point-of-wounding care that, similar to TCCC, focused on bleeding control.2 TECC recommends using a tourniquet for point of wounding care for life-threatening extremity bleeding.3 This clinical review discusses tourniquet use for extremity hemorrhage in the civilian environment and reviews available outcome data to determine whether civilian tourniquet use has been shown to improve survival for patients with extremity hemorrhage.
Johnson JC. Hemorrhage Control in Civilian Extremity Hemorrhage: Does Tourniquet Use Improve Survival?. Lynchburg Journal of Medical Science. 2019; 1(3).
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