PREHOSPITAL TOURNIQUET USE IN KOCHI PREFECTURE

ObjectiveTo investigate the effectiveness and problems of prehospital tourniquet use in our hospital.MethodsThos was a single-center retrospective study. Subjects were trauma patients with an Injury Severity Score (ISS) of 9 or higher who were transported to our hospital between 2019 and 2022.Result...

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Published inJournal of the Japanese Association for the Surgery of Trauma Vol. 38; no. 3; pp. 429 - 434
Main Authors KOMATSUBARA, Tadashi, MATSUMOTO, Toshiyuki, OKUDA, Ryuichiro, YAMAKAWA, Yasuaki
Format Journal Article
LanguageJapanese
Published The Japanese Association for the Surgery of Trauma 20.07.2024
一般社団法人 日本外傷学会
Subjects
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ISSN1340-6264
2188-0190
DOI10.11382/jjast.38.3_01

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Abstract ObjectiveTo investigate the effectiveness and problems of prehospital tourniquet use in our hospital.MethodsThos was a single-center retrospective study. Subjects were trauma patients with an Injury Severity Score (ISS) of 9 or higher who were transported to our hospital between 2019 and 2022.ResultsA total of 853 trauma patients were included in this study. There were 194 upper- and 459 lower-extremity trauma cases. Five patients had a tourniquet applied, their median age was 57 years (range, 43 - 83 years), all were male, and they involved two upper- and three lower-extremity trauma cases. One of the five cases had arterial injury (peroneal artery injury). Complications caused by tourniquet use included deep vein thrombosis in one patient and insufficient pressure that contributed to venous hemorrhage in another patient.ConclusionWhile tourniquet use was effective, there were some associated complications. The duration of tourniquet use exceeded two hours in some cases, and this is an issue that needs to be improved.
AbstractList ObjectiveTo investigate the effectiveness and problems of prehospital tourniquet use in our hospital.MethodsThos was a single-center retrospective study. Subjects were trauma patients with an Injury Severity Score (ISS) of 9 or higher who were transported to our hospital between 2019 and 2022.ResultsA total of 853 trauma patients were included in this study. There were 194 upper- and 459 lower-extremity trauma cases. Five patients had a tourniquet applied, their median age was 57 years (range, 43 - 83 years), all were male, and they involved two upper- and three lower-extremity trauma cases. One of the five cases had arterial injury (peroneal artery injury). Complications caused by tourniquet use included deep vein thrombosis in one patient and insufficient pressure that contributed to venous hemorrhage in another patient.ConclusionWhile tourniquet use was effective, there were some associated complications. The duration of tourniquet use exceeded two hours in some cases, and this is an issue that needs to be improved. 目的 高知県の三次救急病院の一つである当院において, 病院前ターニケット使用の実情について調査し, 有効性や問題点を検討する.方法 単施設後方視的研究. 対象は2019年から2022年までの間に, 当院へ救急搬送されたISS (Injury Severity Score) が9以上の外傷患者である.結果 調査期間中の対象外傷患者は全853例であり, うち上肢外傷が194例, 下肢外傷が459例であった. 病院前ターニケット使用例は5例であり, 年齢は中央値57歳 (範囲43~83歳), 全例男性, 上肢2例, 下肢3例であった. 5例中1例のみ動脈損傷 (腓骨動脈損傷) を認めた. ターニケット装着時間は中央値50分 (範囲35~267分) であった. ターニケットによる合併症として, 大腿静脈内血栓が1例, 圧不足による静脈性出血の助長が1例あった.結語 ターニケットが有効であった症例がある一方で, 使用法の間違いや長時間の使用による合併症もみられた. ターニケット継続時間が2時間を超える症例もみられ, 今後改善すべき課題と考えられる.
ObjectiveTo investigate the effectiveness and problems of prehospital tourniquet use in our hospital.MethodsThos was a single-center retrospective study. Subjects were trauma patients with an Injury Severity Score (ISS) of 9 or higher who were transported to our hospital between 2019 and 2022.ResultsA total of 853 trauma patients were included in this study. There were 194 upper- and 459 lower-extremity trauma cases. Five patients had a tourniquet applied, their median age was 57 years (range, 43 - 83 years), all were male, and they involved two upper- and three lower-extremity trauma cases. One of the five cases had arterial injury (peroneal artery injury). Complications caused by tourniquet use included deep vein thrombosis in one patient and insufficient pressure that contributed to venous hemorrhage in another patient.ConclusionWhile tourniquet use was effective, there were some associated complications. The duration of tourniquet use exceeded two hours in some cases, and this is an issue that needs to be improved.
Author MATSUMOTO, Toshiyuki
YAMAKAWA, Yasuaki
OKUDA, Ryuichiro
KOMATSUBARA, Tadashi
Author_FL 山川 泰明
奥田 龍一郎
小松原 将
松本 俊之
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  fullname: KOMATSUBARA, Tadashi
  organization: Department of Orthopaedic Surgery, Kochi Health Sciences Center
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  organization: Department of Orthopaedic Surgery, Kochi Health Sciences Center
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  fullname: YAMAKAWA, Yasuaki
  organization: Department of Orthopaedic Surgery, Kochi Health Sciences Center
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References 2) 平成29年度救急業務のあり方に関する検討会テロ災害等の対応力向上小会合 : テロ災害等の対応力向上. テロ災害等の対応力向上としての止血に関する教育テキスト. 東京 : 消防庁, 2018 : 1-14.
3) Beekley AC, Sebesta JA, Blackbourne LH, et al : Prehospital tourniquet use in Operation Iraqi Freedom : effect on hemorrhage control and outcomes. J Trauma 2018 ; 64 (2 Suppl) : S28-37.
1) Jacobs LM, Wade DS, McSwain NE, et al : The Hartford Consensus : THREAT, a medical disaster preparedness concept. J Am Coll Surg 2013 ; 217 : 947-953.
4) Konrad G, Markmiller M, Lenich A, et al : Tourniquets may increase postoperative swelling and pain after internal fixation of ankle fractures. Clin Orthop Relat Res 2005 ; 433 : 189-194.
5) BenÍtez CY, Ottolino P, Pereira BM, et al : Tourniquet use for civilian extremity hemorrhage : systematic review of the literature. Rev Col Bras Cir 2021 ; 48 : e20202783.
6) Inaba K, Siboni S, Resnick S, et al : Tourniquet use for civilian extremity trauma. Journal of Trauma and Acute Care Surgery 2015 ; 79 : 232-237.
References_xml – reference: 2) 平成29年度救急業務のあり方に関する検討会テロ災害等の対応力向上小会合 : テロ災害等の対応力向上. テロ災害等の対応力向上としての止血に関する教育テキスト. 東京 : 消防庁, 2018 : 1-14.
– reference: 5) BenÍtez CY, Ottolino P, Pereira BM, et al : Tourniquet use for civilian extremity hemorrhage : systematic review of the literature. Rev Col Bras Cir 2021 ; 48 : e20202783.
– reference: 3) Beekley AC, Sebesta JA, Blackbourne LH, et al : Prehospital tourniquet use in Operation Iraqi Freedom : effect on hemorrhage control and outcomes. J Trauma 2018 ; 64 (2 Suppl) : S28-37.
– reference: 4) Konrad G, Markmiller M, Lenich A, et al : Tourniquets may increase postoperative swelling and pain after internal fixation of ankle fractures. Clin Orthop Relat Res 2005 ; 433 : 189-194.
– reference: 6) Inaba K, Siboni S, Resnick S, et al : Tourniquet use for civilian extremity trauma. Journal of Trauma and Acute Care Surgery 2015 ; 79 : 232-237.
– reference: 1) Jacobs LM, Wade DS, McSwain NE, et al : The Hartford Consensus : THREAT, a medical disaster preparedness concept. J Am Coll Surg 2013 ; 217 : 947-953.
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Snippet ObjectiveTo investigate the effectiveness and problems of prehospital tourniquet use in our hospital.MethodsThos was a single-center retrospective study....
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StartPage 429
SubjectTerms extremity trauma
limb amputation
prehospital care
tourniquet
vascular injury
ターニケット
切断肢
四肢外傷
病院前診療
血管損傷
Title PREHOSPITAL TOURNIQUET USE IN KOCHI PREFECTURE
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