Observational studyAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2025
The cost of saving lives: Complications arising from prehospital tourniquet application.
Observational study in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Prehospital emergency response in a partial hand amputation with ulnar artery transection: a case report.International journal of surgery case reports · 2026Article
- RECOVER Guidelines: First Aid in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2026Article
- The cost of saving lives: Complications arising from prehospital tourniquet application.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Observational
- The Use of TRAUMAGELOpen access emergency medicine : OAEM · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors.
methodsThis retrospective observational study reviewed the medical records of adult trauma casualties (>18 years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data.
resultsFrom 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ-related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2 min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (p < 0.05). Logistic regression analyses revealed length of stay (LOS) and injuries from falls were significantly associated with the development of complications.
conclusionsThis study found that a significant trauma in prehospital settings requiring TQ application is associated with a high rate of complications. Early complications, including local infections and compartment syndrome, were more frequent, whereas late complications like thromboembolism and muscle atrophy were less common. The findings suggest that factors such as the MOI and wound contamination may contribute to these complications, yet after applying multivariate regression, LOS and falls were the only variables found to be significantly associated with the development of complications. These findings underscore the need for further research comparing casualties with and without TQ application.
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