Tourniquet Application by Bystanders Fails to Improve Acuity.
Bystander tourniquet placement not associated with improved patient acuity
Tourniquet Application by Bystanders Fails to Improve Acuity.
Civilian prehospital tourniquet application (tourniquet application) has increased over time, and prehospital tourniquet application may be associated with decreased hemorrhagic shock and improved survival.
This study sought to compare the success and short-term outcomes of prehospital tourniquet application by emergency medical services (emergency medical services) or first responders vs. civilian bystanders, hypothesizing that civilian tourniquet application would lead to less improvement in patient acuity than emergency medical services tourniquet application.
The 2017 to 2020 National Emergency Medical Services Information System database was queried for tourniquet application for patients aged ≥20 years.
bystander tourniquets did not improve patient acuity
A total of 3003 patients had prehospital tourniquet application; 85% of these were applied by emergency medical services.
However, tourniquet application by first responders was associated with improved acuity (odds ratio, 1.22; 95% confidence interval, 1.01-1.44, p = 0.02).
Tourniquet application by emergency medical services is associated with improved patient acuity, whereas tourniquet application by bystander placement is not, in the context of a lower success rate of bystander tourniquet application.
Trauma programs should expand outreach to ensure that those with hemorrhagic extremity injuries receive effective tourniquet application when indicated.