Page 139 - Journal of Special Operations Medicine - Summer 2016

Tourniquets in the U.S.

Military - 2003

Lest we forget – most of the U.S. military
went to war in Afghanistan and Iraq
without tourniquets

29

Tourniquet Outcomes in TCCC Tourniquets – Kragh et al
Transition Initiative Report Annals of Surgery 2009

• Sixty-seven successful tourniquet
applications identified
• No avoidable loss of limbs due to tourniquet
use identified
• Ibn Sina Hospital, Baghdad, 2006
Butler, Greydanus, Holcomb • Prehospital tourniquets are saving lives on the battlefield
2006 USAISR Report • 31 lives saved in 6 months period
• 232 patients with tourniquets on 309 limbs
“TCCC: Combat Evaluation 2005” • No limbs lost to tourniquet ischemia
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30 • This paper turned the tide on tourniquets in the military

Preventable Combat Deaths from Tourniquets in the
Not Using Tourniquets US Military

• Maughon – Mil Med 1970: Vietnam
– 193 of 2,600 fatalities “Tourniquets have been the signature success in battlefield
trauma care in Afghanistan and Iraq. Based on the work
– 7.4% of total combat fatalities of Army COL John Kragh and colleagues, the number of
• Kelly – J Trauma 2008: OEF + OIF (2003/4 and 2006) lives saved from this intervention has been estimated to be
– 77 of 982 (in both cohorts of fatalities) between 1,000 and 2,000.”
– 7.8% of total fatalities – no better then Vietnam Davis et al
• Tourniquets became widely used in 2005-2006 Journal of Trauma Acute Care Surg
• Eastridge – J Trauma 2012: OEF + OIF (to Jun 2011) 2014
– 119 of 4,596 fatalities
– 2.6% of total fatalities – a 67% decrease 32 • And the “1,000-2,000 lives saved” estimate was made
in 2008 – six years before the end of the conflicts.

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