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Emergency Medicine Journal 2007;24:584-587; doi:10.1136/emj.2007.046359
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

PREHOSPITAL CARE

Tourniquet use in the civilian prehospital setting

C Lee1, K M Porter1, T J Hodgetts2

1 Academic Department of Traumatology, West Midlands, UK
2 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK

Correspondence to:
Correspondence to:
Dr Caroline Lee
Academic Department of Traumatology, Room 28, Institute of Research & Development, Birmingham Research Park, Vincent Drive, Birmingham, B15 2SQ, UK; drcarolinelee{at}hotmail.com

ABSTRACT

Tourniquets are an effective means of arresting life-threatening external haemorrhage from limb injury. Their use has not previously been accepted practice for pre-hospital civilian trauma care because of significant concerns regarding the potential complications. However, in a few rare situations tourniquet application will be necessary and life-saving. This review explores the potential problems and mistrust of tourniquet use; explains the reasons why civilian pre-hospital tourniquet use may be necessary; defines the clear indications for tourniquet use in external haemorrhage control; and provides practical information on tourniquet application and removal. Practitioners need to familiarise themselves with commercial pre-hospital tourniquets and be prepared to use one without irrational fear of complications in the appropriate cases.


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