The cost of saving lives: Complications arising from prehospital tourniquet application

Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Academic emergency medicine 2024-12
Hauptverfasser: Rittblat, Mor, Gendler, Sami, Tsur, Nir, Radomislensky, Irina, Ziv, Arnona, Bodas, Moran
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue
container_start_page
container_title Academic emergency medicine
container_volume
creator Rittblat, Mor
Gendler, Sami
Tsur, Nir
Radomislensky, Irina
Ziv, Arnona
Bodas, Moran
description Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors. This retrospective observational study reviewed the medical records of adult trauma casualties (>18 years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data. From 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ-related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2 min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (p 
doi_str_mv 10.1111/acem.15070
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146917033</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3146917033</sourcerecordid><originalsourceid>FETCH-LOGICAL-c212t-1b672583be5ea146a62bf4e033612b3a856f3b36e9897180e5d3082907386d093</originalsourceid><addsrcrecordid>eNo9kE1LAzEQhoMotlYv_gDJUYSt-WiSjTcpfkHBS8Xjkt3O2sjuZk2yhf57U1s7lxmYZ16GB6FrSqY01b2poJ1SQRQ5QWMqBM-Youw0zUTqTArJR-gihG9CiFBanaMR1zKXqcboc7kGXLkQsatxMBvbfeHGbiA84Llr-8ZWJlrXBWy8Dbtl7V2Lew9rF3obTYOjG3xnfwaI2PTHg0t0VpsmwNWhT9DH89Ny_pot3l_e5o-LrGKUxYyWUjGR8xIEGDqTRrKyngHhXFJWcpMLWfOSS9C5VjQnIFac5EwTxXO5IppP0O0-t_cu_RBi0dpQQdOYDtwQCp5CNVUpMKF3e7TyLgQPddF72xq_LSgpdiKLncjiT2SCbw65Q9nC6oj-m-O_ntJuVw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146917033</pqid></control><display><type>article</type><title>The cost of saving lives: Complications arising from prehospital tourniquet application</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rittblat, Mor ; Gendler, Sami ; Tsur, Nir ; Radomislensky, Irina ; Ziv, Arnona ; Bodas, Moran</creator><creatorcontrib>Rittblat, Mor ; Gendler, Sami ; Tsur, Nir ; Radomislensky, Irina ; Ziv, Arnona ; Bodas, Moran</creatorcontrib><description>Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors. This retrospective observational study reviewed the medical records of adult trauma casualties (&gt;18 years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data. From 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ-related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2 min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (p &lt; 0.05). Logistic regression analyses revealed length of stay (LOS) and injuries from falls were significantly associated with the development of complications. This study found that a significant trauma in prehospital settings requiring TQ application is associated with a high rate of complications. Early complications, including local infections and compartment syndrome, were more frequent, whereas late complications like thromboembolism and muscle atrophy were less common. The findings suggest that factors such as the MOI and wound contamination may contribute to these complications, yet after applying multivariate regression, LOS and falls were the only variables found to be significantly associated with the development of complications. These findings underscore the need for further research comparing casualties with and without TQ application.</description><identifier>ISSN: 1069-6563</identifier><identifier>ISSN: 1553-2712</identifier><identifier>EISSN: 1553-2712</identifier><identifier>DOI: 10.1111/acem.15070</identifier><identifier>PMID: 39686666</identifier><language>eng</language><publisher>United States</publisher><ispartof>Academic emergency medicine, 2024-12</ispartof><rights>2024 The Author(s). Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c212t-1b672583be5ea146a62bf4e033612b3a856f3b36e9897180e5d3082907386d093</cites><orcidid>0000-0003-0553-2228</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39686666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rittblat, Mor</creatorcontrib><creatorcontrib>Gendler, Sami</creatorcontrib><creatorcontrib>Tsur, Nir</creatorcontrib><creatorcontrib>Radomislensky, Irina</creatorcontrib><creatorcontrib>Ziv, Arnona</creatorcontrib><creatorcontrib>Bodas, Moran</creatorcontrib><title>The cost of saving lives: Complications arising from prehospital tourniquet application</title><title>Academic emergency medicine</title><addtitle>Acad Emerg Med</addtitle><description>Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors. This retrospective observational study reviewed the medical records of adult trauma casualties (&gt;18 years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data. From 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ-related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2 min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (p &lt; 0.05). Logistic regression analyses revealed length of stay (LOS) and injuries from falls were significantly associated with the development of complications. This study found that a significant trauma in prehospital settings requiring TQ application is associated with a high rate of complications. Early complications, including local infections and compartment syndrome, were more frequent, whereas late complications like thromboembolism and muscle atrophy were less common. The findings suggest that factors such as the MOI and wound contamination may contribute to these complications, yet after applying multivariate regression, LOS and falls were the only variables found to be significantly associated with the development of complications. These findings underscore the need for further research comparing casualties with and without TQ application.</description><issn>1069-6563</issn><issn>1553-2712</issn><issn>1553-2712</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kE1LAzEQhoMotlYv_gDJUYSt-WiSjTcpfkHBS8Xjkt3O2sjuZk2yhf57U1s7lxmYZ16GB6FrSqY01b2poJ1SQRQ5QWMqBM-Youw0zUTqTArJR-gihG9CiFBanaMR1zKXqcboc7kGXLkQsatxMBvbfeHGbiA84Llr-8ZWJlrXBWy8Dbtl7V2Lew9rF3obTYOjG3xnfwaI2PTHg0t0VpsmwNWhT9DH89Ny_pot3l_e5o-LrGKUxYyWUjGR8xIEGDqTRrKyngHhXFJWcpMLWfOSS9C5VjQnIFac5EwTxXO5IppP0O0-t_cu_RBi0dpQQdOYDtwQCp5CNVUpMKF3e7TyLgQPddF72xq_LSgpdiKLncjiT2SCbw65Q9nC6oj-m-O_ntJuVw</recordid><startdate>20241216</startdate><enddate>20241216</enddate><creator>Rittblat, Mor</creator><creator>Gendler, Sami</creator><creator>Tsur, Nir</creator><creator>Radomislensky, Irina</creator><creator>Ziv, Arnona</creator><creator>Bodas, Moran</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0553-2228</orcidid></search><sort><creationdate>20241216</creationdate><title>The cost of saving lives: Complications arising from prehospital tourniquet application</title><author>Rittblat, Mor ; Gendler, Sami ; Tsur, Nir ; Radomislensky, Irina ; Ziv, Arnona ; Bodas, Moran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c212t-1b672583be5ea146a62bf4e033612b3a856f3b36e9897180e5d3082907386d093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rittblat, Mor</creatorcontrib><creatorcontrib>Gendler, Sami</creatorcontrib><creatorcontrib>Tsur, Nir</creatorcontrib><creatorcontrib>Radomislensky, Irina</creatorcontrib><creatorcontrib>Ziv, Arnona</creatorcontrib><creatorcontrib>Bodas, Moran</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Academic emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rittblat, Mor</au><au>Gendler, Sami</au><au>Tsur, Nir</au><au>Radomislensky, Irina</au><au>Ziv, Arnona</au><au>Bodas, Moran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The cost of saving lives: Complications arising from prehospital tourniquet application</atitle><jtitle>Academic emergency medicine</jtitle><addtitle>Acad Emerg Med</addtitle><date>2024-12-16</date><risdate>2024</risdate><issn>1069-6563</issn><issn>1553-2712</issn><eissn>1553-2712</eissn><abstract>Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors. This retrospective observational study reviewed the medical records of adult trauma casualties (&gt;18 years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data. From 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ-related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2 min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (p &lt; 0.05). Logistic regression analyses revealed length of stay (LOS) and injuries from falls were significantly associated with the development of complications. This study found that a significant trauma in prehospital settings requiring TQ application is associated with a high rate of complications. Early complications, including local infections and compartment syndrome, were more frequent, whereas late complications like thromboembolism and muscle atrophy were less common. The findings suggest that factors such as the MOI and wound contamination may contribute to these complications, yet after applying multivariate regression, LOS and falls were the only variables found to be significantly associated with the development of complications. These findings underscore the need for further research comparing casualties with and without TQ application.</abstract><cop>United States</cop><pmid>39686666</pmid><doi>10.1111/acem.15070</doi><orcidid>https://orcid.org/0000-0003-0553-2228</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1069-6563
ispartof Academic emergency medicine, 2024-12
issn 1069-6563
1553-2712
1553-2712
language eng
recordid cdi_proquest_miscellaneous_3146917033
source Wiley Online Library Journals Frontfile Complete
title The cost of saving lives: Complications arising from prehospital tourniquet application
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T12%3A42%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20cost%20of%20saving%20lives:%20Complications%20arising%20from%20prehospital%20tourniquet%20application&rft.jtitle=Academic%20emergency%20medicine&rft.au=Rittblat,%20Mor&rft.date=2024-12-16&rft.issn=1069-6563&rft.eissn=1553-2712&rft_id=info:doi/10.1111/acem.15070&rft_dat=%3Cproquest_cross%3E3146917033%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3146917033&rft_id=info:pmid/39686666&rfr_iscdi=true