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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...

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Autores principales: Heldenberg, Eitan, Aharony, Shahar, Wolf, Tamir, Vishne, Tali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
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.
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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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