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Evaluating new types of tourniquets by the Israeli Naval special warfare unit
BACKGROUND: Extremity injuries, which accounts for 20% of all battlefield injuries, result in 7-9% of deaths during military activity. Silicone tourniquets were used, by the Israeli Defense Force (IDF) soldiers, for upper extremity and calf injuries, while thigh injuries were treated by an improvise...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327874/ https://www.ncbi.nlm.nih.gov/pubmed/28265416 http://dx.doi.org/10.1186/2054-314X-1-1 |
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author | Heldenberg, Eitan Aharony, Shahar Wolf, Tamir Vishne, Tali |
author_facet | Heldenberg, Eitan Aharony, Shahar Wolf, Tamir Vishne, Tali |
author_sort | Heldenberg, Eitan |
collection | PubMed |
description | BACKGROUND: Extremity injuries, which accounts for 20% of all battlefield injuries, result in 7-9% of deaths during military activity. Silicone tourniquets were used, by the Israeli Defense Force (IDF) soldiers, for upper extremity and calf injuries, while thigh injuries were treated by an improvised "Russian" tourniquet (IRT). This is the first study, performed in the IDF, comparing the IRT with Combat Application Tourniquets (CAT) and Special Operations Force Tactical Tourniquets (SOFTT). 23 operators from the Israeli Naval Unit (Shayetet 13) were divided into two groups according to their medical training (11 operators trained as first-responders; 12 operators as medics). Repetitive applications of the three tourniquets over the thigh and upper arm, and self-application of the CAT and SOFTT over the dominant extremity were performed using dry and wet tourniquets (828 individual placements) with efficacy recorded. Cessation of distal arterial flow (palpation; Doppler ultrasound) confirmed success, while failure was considered in the advent of arterial flow or tourniquet instability. Satisfaction questionnaires were filled by the operators. RESULTS: CAT and SOFTT were found to be superior to the IRT, in occluding arterial blood flow to the extremities (22%, 23% and 38%, respectively, failure rate). The application was quicker for the CAT and SOFTT as compared to the IRT (18, 26, 52 seconds, respectively). Wet tourniquets neither prolonged application nor did they increase failure rates. Similarly, medics didn't have any advantage over non-medic operators. No findings indicated superiority of CAT and SOFTT over one another, despite operators’ preference of CAT. CONCLUSIONS: CAT and SOFTT offer an effective alternative to the IRT in stopping blood flow to extremities. No difference was observed between medics and non-medic operators. Thus, the CAT was elected as the preferred tourniquet by our unit and it is being used by all the operators. |
format | Online Article Text |
id | pubmed-5327874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53278742017-03-06 Evaluating new types of tourniquets by the Israeli Naval special warfare unit Heldenberg, Eitan Aharony, Shahar Wolf, Tamir Vishne, Tali Disaster Mil Med Research Article BACKGROUND: Extremity injuries, which accounts for 20% of all battlefield injuries, result in 7-9% of deaths during military activity. Silicone tourniquets were used, by the Israeli Defense Force (IDF) soldiers, for upper extremity and calf injuries, while thigh injuries were treated by an improvised "Russian" tourniquet (IRT). This is the first study, performed in the IDF, comparing the IRT with Combat Application Tourniquets (CAT) and Special Operations Force Tactical Tourniquets (SOFTT). 23 operators from the Israeli Naval Unit (Shayetet 13) were divided into two groups according to their medical training (11 operators trained as first-responders; 12 operators as medics). Repetitive applications of the three tourniquets over the thigh and upper arm, and self-application of the CAT and SOFTT over the dominant extremity were performed using dry and wet tourniquets (828 individual placements) with efficacy recorded. Cessation of distal arterial flow (palpation; Doppler ultrasound) confirmed success, while failure was considered in the advent of arterial flow or tourniquet instability. Satisfaction questionnaires were filled by the operators. RESULTS: CAT and SOFTT were found to be superior to the IRT, in occluding arterial blood flow to the extremities (22%, 23% and 38%, respectively, failure rate). The application was quicker for the CAT and SOFTT as compared to the IRT (18, 26, 52 seconds, respectively). Wet tourniquets neither prolonged application nor did they increase failure rates. Similarly, medics didn't have any advantage over non-medic operators. No findings indicated superiority of CAT and SOFTT over one another, despite operators’ preference of CAT. CONCLUSIONS: CAT and SOFTT offer an effective alternative to the IRT in stopping blood flow to extremities. No difference was observed between medics and non-medic operators. Thus, the CAT was elected as the preferred tourniquet by our unit and it is being used by all the operators. BioMed Central 2015-01-27 /pmc/articles/PMC5327874/ /pubmed/28265416 http://dx.doi.org/10.1186/2054-314X-1-1 Text en © Heldenberg et al.; licensee BioMed Central. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Heldenberg, Eitan Aharony, Shahar Wolf, Tamir Vishne, Tali Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title | Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title_full | Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title_fullStr | Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title_full_unstemmed | Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title_short | Evaluating new types of tourniquets by the Israeli Naval special warfare unit |
title_sort | evaluating new types of tourniquets by the israeli naval special warfare unit |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327874/ https://www.ncbi.nlm.nih.gov/pubmed/28265416 http://dx.doi.org/10.1186/2054-314X-1-1 |
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