Aim The past decade has seen increasing civilian tourniquet use driven largely by a military evidence base1. This work intended to correlate available data on the frequency of UK prehospital tourniquet use.

Methods Freedom of information requests were made to 13 UK ambulance trusts for numbers of the incidence of tourniquet use from 2015–16 and patient haemodynamic status (blood pressure and pulse) at time of application.

Results Most (9/13) trusts were unable to provide data regarding prehospital haemorrhage control techniques as this something that was not routinely recorded. Two trusts had only recently begun recording tourniquet use and so were unable to provide 12 months of data and another was able to deliver number of recorded uses but not patient haemodynamic status. A single trust was able to provide full details of annual tourniquet use in 31 patients. 14/31 (45%) of patients had a systolic BP of <100 mmHg and a further 6/31 (19%) had a pulse >100/min at application. 2 patients had a haemostatic pressure dressing applied before tourniquet use.

Conclusion There is a significant lack of data regarding UK ambulance service tourniquet use and this should be urgently increased to improve both research and clinical governance. Many (45%) patients are already in significant levels of shock prior to application of tourniquet use which is associated with very high levels of mortality2 and only further data collection will help to understand and ultimately address the reasons underlying this.

References

1. Bulger EM, Snyder D, & Schoelles K, et al. An evidence-based prehospital guideline for external haemorrhage control: American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014;18(2):163–173.

2. Kragh JF, Littrel ML, & Jones JA, et al. Battle casualty survival with emergency tourniquet use to stop limb bleeding. J Emerg Med. 2011;41(6):590–597.

Conflict of interest None declared.

Funding None declared.