Evaluation of emergency tourniquets for prehospital use in China

Abstract

【Abstract】 Objective: Massive hemorrhage is life- threatening during armed conflicts. Tourniquets are impor- tant medical devices used to reduce severe bleeding in trauma. The aim of this study was to empirically evaluate the current tourniquets used in China and provide informa- tion to emergency nurses in selecting the appropriate tourniquet. Methods: Five tourniquets were self-applied by 20 healthy participants. The blood flow distal to the tourni- quet site was assessed using vascular Doppler ultrasound. Application time, pain, numbness, and other parameters were evaluated. Results: The bladder tourniquet and windlass tourni- quet effectively occluded arterial blood flow with success rates higher than 75% in both the upper and lower extremities. The Cargo-strap was the fastest to apply, taking (7.22±2.30) s for the upper extremity and (6.48±2.40) s for the lower extremity. The rubber tube was the most painful, and the improvised tourniquet was the least efficient. The suc- cess rates were higher in the lower extremity than in the upper extremity (P<0.05, Χ2 =5.714). Conclusions: The bladder tourniquet and the wind- lass tourniquet are efficient tourniquets, although the wind- lass is superior with respect to portability and pain. The Cargo-strap and rubber tourniquets have several disadvan- tages that reduce their suitability for field use. The impro- vised tourniquet is not recommended because of low effi- ciency and severe pain during implementation. Key words: Tourniquets; Hemorrhage; Emergency treatment