• Rev Col Bras Cir · Jan 2021

    Tourniquet use for civilian extremity hemorrhage: systematic review of the literature.

    • Carlos YÁnez BenÍtez, Pablo Ottolino, Bruno M Pereira, Daniel Souza Lima, Antonio Guemes, Mansoor Khan, and Ribeiro Junior Marcelo Augusto Fontenelle MAF http://orcid.org/0000-0001-9826-4722 - Catholic University of São Paulo PUCSP-Sorocaba, Discipline of Ge.
    • - Royo Villanova Hospital, SALUD, General, GI and Acute Care Surgery Department - Zaragoza - Zaragoza - Espanha.
    • Rev Col Bras Cir. 2021 Jan 1; 48: e20202783.

    Introductionextremity tourniquet (TQ) use has increased in the civilian setting; the beneficial results observed in the military has influenced acceptance by EMS and bystanders. This review aimed to analyze extremity TQ types used in the civilian setting, injury site, indications, and complications.Methodsa systematic review was conducted based on original articles published in PubMed, Embase, and Cochrane following PRISMA guidelines from 2010 to 2019. Data extraction focused on extremity TQ use for hemorrhage control in the civilian setting, demographic data, study type and duration, mechanism of injury, indications for use, injury site, TQ type, TQ time, and complications.Resultsof the 1384 articles identified, 14 were selected for review with a total of 3912 civilian victims with extremity hemorrhage and 3522 extremity TQ placements analyzed. The majority of TQs were applied to male (79%) patients, with blunt or penetrating trauma. Among the indications for TQ use were hemorrhagic shock, suspicion of vascular injuries, continued bleeding, and partial or complete traumatic amputations. Upper extremity application was the most common TQ application site (56%), nearly all applied to a single extremity (99%), and only 0,6% required both upper and lower extremity applications. 80% of the applied TQs were commercial devices, and 20% improvised.ConclusionsTQ use in the civilian setting is associated with trauma-related injuries. Most are single-site TQs applied for the most part to male adults with upper extremity injury. Commercial TQs are more commonly employed, time in an urban setting is under 1 hour, with few complications described.

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