Evidence in Support of Tourniquet Use in Major Limb Trauma

For traumatic limb hemorrhage, tourniquet use is common sense. To quantify its benefit, investigators reviewed data from a registry of injured U.S. soldiers in Afghanistan and Iraq. In an analysis of patients with major limb trauma who reached a hospital alive and received blood transfusion, the investigators compared outcomes between 720 patients who were treated with a tourniquet in the field and 693 who were treated without tourniquets. Tourniquet use was at the discretion of personnel in the field.

The tourniquet group had more severe injuries by multiple measures; for example, they received an average of two units of red cells, versus one unit in the no-tourniquet group. However, despite the difference in injury severity, survival was e…