Evidence map›Paper›PMID 29797031›Full record

SynthesisDer Unfallchirurg2018

[Prehospital application of tourniquets for life-threatening extremity hemorrhage : Systematic review of literature].

B Hossfeld, R Lechner, F Josse, M Bernhard, F Walcher, M Helm, M Kulla

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Der Unfallchirurg, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Prehospital Tourniquets in Civilians: A Systematic Review.Prehospital and disaster medicine · 2021
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

B HossfeldKlinik für Anästhesiologie und Intensivmedizin, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
R LechnerKlinik für Anästhesiologie und Intensivmedizin, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
F JosseKlinik für Anästhesiologie und Intensivmedizin, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
M BernhardZentrale Notaufnahme, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
F WalcherUniversitätsklinik für Unfallchirurgie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland.
M HelmKlinik für Anästhesiologie und Intensivmedizin, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
M KullaKlinik für Anästhesiologie und Intensivmedizin, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland. martin.kulla@uni-ulm.de.ORCID http://orcid.org/0000-0001-7454-0876

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe effectiveness of a tourniquet in the case of life-threatening hemorrhages of the extremities is well recognized and led to the recommendations on "Tourniquet" of the German Society of Anaesthesiology and Intensive Care (DGAI) in 2016. The aim of this systematic review was to re-evaluate the current medical literature in relation to the published DGAI recommendations. MATERIAL AND

methodsBased on the analysis of all studies published from January 2015 until January 2018 in the PubMed databases, the publicized recommendations for action on "Tourniquet" of the DGAI were critically re-evaluated. For this purpose, 17 questions on 6 subjects were formulated in advance. The systematic review followed the PRISMA recommendations and is registered in PROSPERO (International prospective register of systematic reviews, Reg.-ID: CRD42018091528).

resultsOf the 284 studies identified with the keywords tourniquet and trauma in the period from January 2015 to January 2018 in PubMed, 50 original papers discussing the prehospital application of tourniquet for life-threatening hemorrhage of the extremities were included. The overall level of evidence is low. No article addressed any of the formulated questions with a prospective randomized interventional study. Scientific deductions could be found only in an indirect way in a descriptive manner.

conclusionThe 50 original articles included in this qualitative, systematic review revealed that the recommendations "Tourniquet" of the DGAI published in 2016 are mostly still up to date despite an inhomogeneous study situation. A deviation occurred in the conversion of a tourniquet but due to the short prehospital treatment time in the civilian setting this is of little importance; however, in the future a strict distinction should be made between tourniquets which were placed for tactical reasons and those placed as a medical necessity.

Indexed as

Emergency Medical ServicesHemorrhageTourniquetsExtremitiesHumansProspective StudiesConversionEmergency care, prehospitalState-of-the-art reviewTime-to-treatmentTrauma

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.