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Survey of Trauma Registry Data on Tourniquet Use in Pediatric War Casualties.
MedLine Citation:
PMID:  23187998     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Previously, we reported on the use of emergency tourniquets to stop bleeding in war casualties, but virtually all the data were from adults. Because no pediatric-specific cohort of casualties receiving emergency tourniquets existed, we aimed to fill knowledge gaps on the care and outcomes of this group by surveying data from a trauma registry to refine device designs and clinical training. METHODS: A retrospective review of data from a trauma registry yielded an observational cohort of 88 pediatric casualties at US military hospitals in theater on whom tourniquets were used from May 17, 2003, to December 25, 2009. RESULTS: Of the 88 casualties in the study group, 72 were male and 16 were female patients. Ages averaged 11 years (median, 11 years; range, 4-17 years). There were 7 dead and 81 survivor outcomes for a trauma survival rate of 93%. Survivor and dead casualties were similar in all independent variables measured except hospital stay duration (median, 5 days and 1 day, respectively). Six casualties (7%) had neither extremity nor external injury in that they had no lesion indicating tourniquet use. CONCLUSIONS: The survival rate of the present study's casualties is similar to that of 3 recent large nonpediatric-specific studies. Although current emergency tourniquets were ostensibly designed for modern adult soldiers, tourniquet makers, perhaps unknowingly, produced tourniquets that fit children. The rate of unindicated tourniquets, 7%, implied that potential users need better diagnostic training. LEVELS OF EVIDENCE: Level 4; case series, therapeutic study.
Authors:
John F Kragh; Arthur Cooper; James K Aden; Michael A Dubick; David G Baer; Charles E Wade; Lorne H Blackbourne
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-26
Journal Detail:
Title:  Pediatric emergency care     Volume:  -     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the *US Army Institute of Surgical Research, Fort Sam Houston, TX; †F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD; ‡Department of Surgery, Harlem Hospital Center, College of Physicians and Surgeons Columbia University, New York, NY; and §University of Texas Health Science Center at Houston, Houston, TX.
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