Surgical Tourniquet Technology Adapted for Military and Prehospital Use
Abstract
In ground-based tactical situations and prehospital settings, the tourniquet is used as a life-saving hemorrhage control device. It must completely stop blood flow, must be fast and simple to self-apply, and must require minimal training. However, an improperly designed or used tourniquet can cause loss of the limb, compromised limb salvage, and systemic effects harmful to the patient; all may result from excess tourniquet pressure, excess tourniquet time, or a tourniquet that is too narrow. Most existing prehospital tourniquets use technology from the 1800's: mechanically tightened narrow bands that apply uncontrolled pressures (e.g. Spanish Windlass). In contrast, the modern pneumatic tourniquet is considered indispensable in common surgical procedures, and is now used thousands of times each day to completely occlude arterial blood flow in limbs continuously throughout surgeries lasting several minutes to several hours, and longer using appropriate techniques. Injury or compromise of limb recovery due to pneumatic tourniquet use in surgery is rare. The purpose of this study was to test a newly developed prehospital pneumatic tourniquet, which is based on proven surgical tourniquet designs. The new device has an inflatable bladder, a manual inflator, and a locking clamp. It weighs 220 g, packs to 570 cubic cm, and fits arms and thighs up to 85 cm circumference. To demonstrate effectiveness at safe pressures, the new tourniquet was applied to adult volunteers. Arterial occlusion (indicated by Doppler stethoscope) was reached at an average pressure of 229 mmHg (SD 32, range 165-302, n = 32) on the thigh and 140 mmHg (SD 17, range 106-175, n = 32) on the upper arm. The tourniquet was then used on thighs in 21 surgical procedures at the normally used pressures of 300-350 mmHg. Good hemostasis was maintained in all cases and there were no complications. Users found the tourniquet very easy to apply after a single demonstration.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2004
- Accession Number
- ADA444880
Entities
People
- James A. Mcewen
- Kevin Inkpen
Organizations
- University of British Columbia