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Pediatr Emerg Care. 2012 Dec;28(12):1361-5. doi: 10.1097/PEC.0b013e318276c260.

Survey of trauma registry data on tourniquet use in pediatric war casualties.

Author information

  • 1US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-6315, USA. john.kragh1@us.army.mil

Abstract

OBJECTIVES:

Previously, we reported on the use of emergency tourniquets to stop bleeding in war casualties, but virtually all the data were from adults. Because no pediatric-specific cohort of casualties receiving emergency tourniquets existed, we aimed to fill knowledge gaps on the care and outcomes of this group by surveying data from a trauma registry to refine device designs and clinical training.

METHODS:

A retrospective review of data from a trauma registry yielded an observational cohort of 88 pediatric casualties at US military hospitals in theater on whom tourniquets were used from May 17, 2003, to December 25, 2009.

RESULTS:

Of the 88 casualties in the study group, 72 were male and 16 were female patients. Ages averaged 11 years (median, 11 years; range, 4-17 years). There were 7 dead and 81 survivor outcomes for a trauma survival rate of 93%. Survivor and dead casualties were similar in all independent variables measured except hospital stay duration (median, 5 days and 1 day, respectively). Six casualties (7%) had neither extremity nor external injury in that they had no lesion indicating tourniquet use.

CONCLUSIONS:

The survival rate of the present study's casualties is similar to that of 3 recent large nonpediatric-specific studies. Although current emergency tourniquets were ostensibly designed for modern adult soldiers, tourniquet makers, perhaps unknowingly, produced tourniquets that fit children. The rate of unindicated tourniquets, 7%, implied that potential users need better diagnostic training.

LEVELS OF EVIDENCE:

Level 4; case series, therapeutic study.

PMID:
23187998
DOI:
10.1097/PEC.0b013e318276c260
[PubMed - indexed for MEDLINE]
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