Morbidity associated with pre-hospital upper-limb tourniquet in civilian trauma: a case series

Abstract

Introduction: The widespread pre-hospital use of tourniquets, particularly in the upper limb, raises questions about associated morbidity, which has been little studied and may have serious consequences for functional prognosis.

Methods: A review of 9 patients was carried out, analyzing pre-hospital tourniquet use in terms of complications affecting recovery.

Results: There were serious complications: musculocutaneous nerve palsy in 1 patient, and compartment syndrome, rhabdomyolysis and ischemia-reperfusion syndrome in another. A role of prolonged pre-hospital tourniquet application in postoperative infection was also suspected in 2 patients.

Discussion: The risk-benefit ratio and indications for using a tourniquet on the upper limb in the pre-hospital setting need to be reconsidered.

Keywords: Amputation; Complication; Damage control; Hand; Pre-hospital; Tourniquet; Trauma.