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.