Pre-hospital tourniquet use in penetrating extremity trauma: decreased blood transfusions and limb complications

Background Despite increasing popularity of pre-hospital tourniquet use in civilians, few studies have evaluated the efficacy and safety of tourniquet use. Furthermore, previous studies in civilian populations have focused on blunt trauma patients. The objective of this study was to determine if pre-hospital tourniquet use in patients with major penetrating trauma is associated with differences in outcomes compared to a matched control group. Methods An eight-year retrospective analysis of adult patients with penetrating major extremity trauma amenable to tourniquet use (major vascular trauma, traumatic amputation and near-amputation) was performed at a level I trauma center. Patients with pre-hospital tourniquet placement (TQ) were identified and compared to a matched group of patients without tourniquets (N-TQ). Univariate analysis was used to compare outcomes in the groups. Results A total of 204 patients were matched with 127 (62.3%) in the pre-hospital TQ group. No differences in patient demographics or injury severity existed between the two groups. Average time from tourniquet application to arrival in the ED was 22.5+1.3 minutes. Patients in the TQ group had higher average SBP on arrival in the ED (120+2 vs. 112+2, p=0.003). TQ group required less total PRBCs (2.0+0.1 vs. 9.3+0.6, p

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