Tourniquets for hemorrhage control on the battlefield: A 4-year accumulated experience

Background: Tourniquet application is a known means for bleeding prevention in the military prehospital setting. Methods: This study was a 4-year retrospective analysis of silicone and improvised tourniquet applications by Israeli Defense Force soldiers. Results: Of 550 soldiers who were treated in the prehospital setting, tourniquets were applied to 91 (16%) patients and in less than 15 minutes in 88% of the cases with almost no complications. Penetrating trauma was the main mechanism of injury. The indication was situational and nonmedical in 58 (53%) of the cases. The patients' ischemic time was 83 ± 52 minutes (range, 1-305 minutes). A total of 78% of applications were effective, with higher success rates for medical staff compared with fellow soldiers and for upper limbs (94%) compared with lower limbs (71%, p < 0.01). Conclusion: Tourniquet application is an effective and easily applied (by medical and nonmedical personnel) method for prevention of exsanguination in the military prehospital setting.