Hemostatic dressing
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
II
|
Supportive (Green)
|
Effectiveness
|
Patient
|
PH-Paramedic
|
Boulton AJ., Lewis CT., Naumann DN., Midwinter MJ. Prehospital haemostatic dressings for trauma a systematic review. EMJ 2018; 35(7) 449-57. Medline
|
II
|
Supportive (Green)
|
Cessation of bleeding
|
Patient
|
Other
|
Charlton NP, Swain JM, Brozek JL, Ludwikowska M, Singletary E, Zideman D, et al. Control of Severe, Life-Threatening External Bleeding in the Out-of-Hospital Setting: A Systematic Review. Prehosp Emerg Care 2021; 25(2):235-67. Medline
|
II
|
Supportive (Green)
|
Efficacy
|
Patient
|
|
Leonard J., Zietlow J., Morris D., et al. A multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma. The journal of Trauma and Acute Care Surgery 2016; 81(3):441-4. Medline
|
III
|
Supportive (Green)
|
Cessation of bleeding
|
Patient
|
PH-Paramedic
|
Brown M., Daya M., Worley J. Experience with chitosan dressings in a civilian EMS system. J Emerg Med 2009; 37(1):1-7. Medline
|
III
|
Supportive (Green)
|
Cessation of bleeding
|
Process
|
ED-MD
|
Cox E., Schreiber M., McManus J., Wade C., Holcomb J. New hemostatic agents in the combat setting. Transfusion 2009; 49 (S5):248S-55S. Medline
|
III
|
Supportive (Green)
|
Blood loss
|
Patient
|
|
Kheirabadi BS., Edens JW., Terrazas IB., Estep JS., Klemcke HG., Dubick MA., Holcomb JB. Comparison of new hemostatic granules/powders with currently deployed hemostatic products in a lethal model of extremity arterial hemorrhage in swine. J Trauma 2009; 66(2):316-28. Medline
|
III
|
Supportive (Green)
|
Hemorrhage Control
|
Patient
|
PH-Paramedic
|
Ran Y., Hadad E., Daher S., Ganor O., Kohn J., Yegorov Y., Bartal C., Ash N., Hirschhorn G. QuikClot Combat Gauze Use for Hemorrhage Control in Military Trauma: January 2009 Israel Defense Force Experience in the Gaza Strip—A Preliminary Report of 14 Cases. Prehosp and Dis Med 2010; 25(6):584-8. Medline
|
III
|
Supportive (Green)
|
Hemorrhage Control
|
Patient
|
PH-Paramedic
|
Wedmore I., McManus J., Pusateri A., Holcomb J. A Special Report on the Chitosan-based Hemostatic Dressing: Experience in Current Combat Operations. J Trauma 2006; 60(3):655-8. Medline
|
III
|
Supportive (Green)
|
Survival
|
Patient
|
Other
|
Welch M., Barratt J., Peters A., Wright C. Systematic review of prehospital haemostatic dressings. J R Army Med Corps 2019. Medline
|
III
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
Granville-Chapman J., Jacobs N., Midwinter MJ. Pre-hospital haemostatic dressings: A systematic review. Injury 2011; 2(5):447-59. Medline
|
III
|
Neutral (Yellow)
|
correct performance of intervention
|
Patient
|
PH-Paramedic
|
Lairet JR., Bebarta VS., Burns CJ., Lairet KF., Rasmussen TE., Renz EM., et al. Prehospital interventions performed in a combat zone: a prospective multicenter study of 1,003 combat wounded. J Trauma Acute Care Surg 2012; 73(2S1):S38-42. Medline
|
III
|
Neutral (Yellow)
|
Hemorrhage control
|
Process
|
Other
|
Schauer SG., April MD., Naylor JF., Fisher AD., Cunningham CW., Ryan KL., et al. QuikClot® Combat Gauze® Use by Ground Forces in Afghanistan The Prehospital Trauma Registry Experience. Journal of special operations medicine; 17(2) 101-6. Medline
|
Tourniquet (limb)
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
II
|
Supportive (Green)
|
Effectiveness and complication rate.
|
Patient
|
PH-Bystander
|
Beaucreux C., Vivien B., Miles E., Ausset S., Pasquier P. Application of tourniquet in civilian trauma Systematic review of the literature. Anaesthesia, critical care & pain medicine 2018; 37(6) 597-606. Medline
|
II
|
Supportive (Green)
|
Efficacy
|
Patient
|
PH-Paramedic
|
Bedri H, Ayoub H, Engelbart JM, Lilienthal M, Galet C, Skeete DA. Tourniquet Application for Bleeding Control in a Rural Trauma System: Outcomes and Implications for Prehospital Providers. Prehosp Emerg Care 2021:1-9. Medline
|
II
|
Supportive (Green)
|
Hemorrhage control
|
Patient
|
Other
|
Charlton NP, Swain JM, Brozek JL, Ludwikowska M, Singletary E, Zideman D, et al. Control of Severe, Life-Threatening External Bleeding in the Out-of-Hospital Setting: A Systematic Review. Prehosp Emerg Care 2021; 25(2):235-67. Medline
|
II
|
Supportive (Green)
|
In hospital mortality
|
Patient
|
PH-Paramedic
|
Henry R, Matsushima K, Ghafil C, Henry RN, Theeuwen H, Golden AC, et al. Increased Use of Prehospital Tourniquet and Patient Survival: Los Angeles Countywide Study. J Am Coll Surg 2021. Medline
|
II
|
Supportive (Green)
|
Morbidity
|
Patient
|
PH-Paramedic
|
Kragh JF, Jr. Practical Use Emerg Tourniquets. Journal of Trauma 2008; 64(2):S38-50. Medline
|
II
|
Supportive (Green)
|
-
|
Patient
|
|
Kragh JF, Jr. Survival With Emergency Tourniquet Use to Stop Bleeding in Major Limb Trauma. Ann Surgery 2009; 249(1):1-7. Medline
|
II
|
Supportive (Green)
|
Efficacy
|
Patient
|
|
Leonard J., Zietlow J., Morris D., et al. A multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma. The journal of Trauma and Acute Care Surgery 2016; 81(3):441-4. Medline
|
II
|
Supportive (Green)
|
Feasibility
|
Process
|
PH-Paramedic & CCT
|
Passos E., Dingley B., Smith A., Engels PT., Ball CG., Faidi S., Nathens A., Tien H. Tourniquet use for peripheral vascular injuries in the civilian setting. Injury 2014; 45(3):573-7. Medline
|
II
|
Supportive (Green)
|
Death from hemorrhage
|
Patient
|
ED-Paramedic & CCP
|
Scerbo MH, Holcomb JB, Taub E, Gates K, Love JD, Wade CE, et al. The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. The journal of trauma and acute care surgery 2017; 83(6):1165-72. Medline
|
II
|
Supportive (Green)
|
Death by hemorrhagic shock
|
Patient
|
ED-Paramedic & MD
|
Scerbo MH, Holcomb JB, Taub E, Gates K, Love JD, Wade CE, et al. The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. The journal of trauma and acute care surgery 2017; 83(6):1165-72. Medline
|
II
|
Supportive (Green)
|
Safety
|
Patient
|
PH-Paramedic
|
Schroll R., Smith A., McSwain NE., Jr, et al. A multi-institutional analysis of prehospital tourniquet use. J Trauma Acute Care Surg 2015; 79(1):10-4; discussion 14. Medline
|
II
|
Supportive (Green)
|
blood product utilization
|
Patient
|
PH-Paramedic
|
Smith AA., Ochoa JE., Wong S., Beatty S., Elder J., Guidry C., et al. Prehospital tourniquet use in penetrating extremity trauma Decreased blood transfusions and limb complications. The journal of trauma and acute care surgery 2019; 86(1) 43-51. Medline
|
II
|
Supportive (Green)
|
In hospital mortality.
|
Patient
|
PH-Paramedic
|
Teixeira PGR., Brown CVR., Emigh B., Long M., Foreman M., Eastridge B., et al. Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. J Am Coll Surg 2018; 226(5) 769-76. Medline
|
II
|
Neutral (Yellow)
|
Time to artery occlusion
|
Patient
|
PH-Paramedic
|
King RB., Filips D., Blitz S., Logsetty S. Evaluation of possible tourniquet systems for use in the Canadian Forces. J Trauma 2006; 60:1061-71. Medline
|
II
|
Neutral (Yellow)
|
Mortality
|
Patient
|
|
Kragh J., Nam J., Berry K., Mase V., Aden J., Walters T., Dubick M., Baer D., Wade N., Blackbourne L. Transfusion for Shock in US Military War Casualties With and Without Tourniquet Use. Ann Emerg Med 2015; 65(3):290-6 Medline
|
II
|
Neutral (Yellow)
|
Appropriate use
|
Patient
|
ED-MD
|
Mikdad S, Mokhtari AK, Luckhurst CM, Breen KA, Liu B, Kaafarani HM, et al. Implications of the national Stop the Bleed campaign: The swinging pendulum of prehospital tourniquet application in civilian limb trauma. J Trauma Acute Care Surg 2021; 91(2):352–60. Medline
|
II
|
Neutral (Yellow)
|
In-hospital mortality
|
Patient
|
|
Passos E., Dingley B., Smith A., Engels P., Ball C., Faidi S., Nathens A., Tien H. Canadian Trauma Trials Collaborative Tourniquet use for peripheral vascular injuries in the civilian setting. Injury 2014; 45(3):573-7. Medline
|
II
|
Opposes (Red)
|
Deep Infection
|
Process
|
PH-Paramedic
|
Beekley A., Sebesta J., Blackbourne L., Herbert G., Kauvar D., Baer D., Walters T., Mullenix P., Holcomb J., Members of the 31st Combat Support Hospital Research Group. Prehospital Tourniquet Use in Operation Iraqi Freedom: Effect on Hemorrhage Control and Outcomes. Jtrauma 2008; 64(2 Suppl):S28-37. Medline
|
II
|
Opposes (Red)
|
Appropriate use
|
Patient
|
PH-Paramedic
|
Duignan KM., Lamb LC., DiFiori MM., Quinlavin J., Feeney JM. Tourniquet use in the prehospital setting Are they being used appropriately? American journal of disaster medicine 2018; 13(1) 37-43. Medline
|
III
|
Supportive (Green)
|
Tourniquet application
|
Patient
|
PH-Bystander
|
Barnard LM, Guan S, Zarmer L, Mills B, Blackwood J, Bulger E, et al. Prehospital tourniquet use: An evaluation of community application and outcome. J Trauma Acute Care Surg 2021; 90(6):1040–7. Medline
|
III
|
Supportive (Green)
|
Mortality
|
Patient
|
PH-Paramedic
|
Brodie S., Hodgetts T., Ollerton J., McLeod J., Lambert P., Mahoney J. Tourniquet Use in Combat Trauma: UK Military Experience. J Spec Oper Med 2007; 9(1):74-7. Medline
|
III
|
Supportive (Green)
|
Controlling hemorrhage
|
Patient
|
|
Gibson R., Aden JK., Dubick MA., Kragh JF. Preliminary comparison of pneumatic models of tourniquet for prehospital control of limb bleeding in a manikin model. J Spoec Ops Med 2016;16(2):21-7. Medline
|
III
|
Supportive (Green)
|
Hemostasis
|
Process
|
SIM
|
Guo J., Liu Y., Ma Y., Pi H., Wang J. Evaluation of emergency tourniquets for prehospital use in China. Chi J Trauma 2011; 14(3):151-5. Medline
|
III
|
Supportive (Green)
|
Bleeding control
|
Patient
|
PH-Paramedic
|
Jacobs LM., Burns KJ., Priest HS., Muskett W. Use of a tourniquet by LIFE STAR air medical crew: A case report. Conn Med 2015; 79(9):537-41. Medline
|
III
|
Supportive (Green)
|
Effectiveness, Mortality, complications
|
Patient
|
|
Kauvar DS., Dubick MA., Walters TJ., Kragh JF. Systematic review of prehospital tourniquet use in civilian limb trauma. The journal of trauma and acute care surgery 2018; 84(5) 819-25. Medline
|
III
|
Supportive (Green)
|
Mortality
|
Patient
|
PH-Paramedic
|
Kragh J., Cooper A., Aden J., Dubick M., Baer D., Wade C., Blackbourne L. Survey of Trauma Registry Data on Tourniquet Use in Pediatric War Casualties. Ped Emerg Care 2012; 28(12):1362-5. Medline
|
III
|
Supportive (Green)
|
Efficacy and Pulse cessation
|
Patient
|
|
Kragh JF., Aden JK., Dubick MA. Evaluation of models of pneumatic tourniquet in simulated out-of-hospital use. Journal of special operations medicine : a peer reviewed journal for SOF medical professionals. 2016;16(3):21-29. Medline
|
III
|
Supportive (Green)
|
Mortality
|
Patient
|
PH-Paramedic
|
Kue R., Temin E., Weiner S., Gates J., Coleman M., Fisher J., Dyer S. Tourniquet Use in a Civilian Emergency Medical Services Setting. A Descriptive Analysis of the Boston EMS Experience. Prehosp Emerg Care 2015; 19(3):399-404 Medline
|
III
|
Supportive (Green)
|
Time to application
|
Process
|
PH-Paramedic
|
Lakstein D., Blumenfeld A., Sokolov T., Lin G., Bssorai R., Lynn M., Ben-Abraham R. Tourniquets for Hemorrhage Control on the Battlefield: A 4-Year Accumulated Experience. J Trauma 2003; 54(5S):S221. Medline
|
III
|
Neutral (Yellow)
|
Time to artery occlusion
|
Patient
|
PH-Paramedic
|
King D., van der Wilden G., Kragh J., Blackbourne L. Forward Assessment of 79 Prehospital Battlefield Tourniquets Used in the Current War. J of Spec Oper Med 2012; 12(4):33-9. Medline
|
III
|
Neutral (Yellow)
|
Mortality
|
Patient
|
|
Kragh J., Littrel M., Jones .J, Walters T., Baer D., Wade C., Holcomb J. Battle Casulty Survival with Emergency Tourniquet Use to Stop Limb Bleeding. J Emerg Med 2011; 41(6):590-7. Medline
|
III
|
Neutral (Yellow)
|
correct performance of intervention
|
Patient
|
PH-Paramedic
|
Lairet JR., Bebarta VS., Burns CJ., Lairet KF., Rasmussen TE., Renz EM., et al. Prehospital interventions performed in a combat zone: a prospective multicenter study of 1,003 combat wounded. J Trauma Acute Care Surg 2012; 73(2S1):S38-42. Medline
|
III
|
Neutral (Yellow)
|
Ease of use
|
Process
|
SIM
|
Lairet JR., Bebarta VS., Burns CJ., Lairet KF., Rasmussen TE., Renz EM., et al. Prehospital interventions performed in a combat zone: a prospective multicenter study of 1,003 combat wounded. J Trauma Acute Care Surg 2012; 73(2S1):S38-42. Medline
|
III
|
Neutral (Yellow)
|
Loss of popliteal pulse
|
Patient
|
SIM
|
Taylor DM., Vater GM., Parker PJ. An evaluation of two tourniquet systems for the control of prehospital lower limb hemorrhage. J Trauma 2011; 71(3):591-595. Medline
|
III
|
Neutral (Yellow)
|
Prediction of 28-day mortality
|
Process
|
ED-MD
|
Wall PL., Duevel DC., Hassan MB., Welander JD., Sahr SM., Buising CM. Tourniquets and occlusion: The pressure of design. Mil Med 2013; 178(5):578-587. Medline
|
X
|
Not Yet Graded (White)
|
-
|
Patient
|
|
Clasper JC., Brown KV., Hill P. Limb complications following pre-hosptial tourniquet use. J R Army Med Corps 2009; 155(3):200-2. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Eilertsen KA, Winberg M, Jeppesen E, Hval G, Wisborg T. Prehospital Tourniquets in Civilians: A Systematic Review. Prehosp Disaster Med 2021; 36(1):86-94. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Latina R, Iacorossi L, Fauci AJ, Biffi A, Castellini G, Coclite D, et al. Effectiveness of Pre-Hospital Tourniquet in Emergency Patients with Major Trauma and Uncontrolled Haemorrhage: A Systematic Review and Meta-Analysis. Int J Env Res Public Heal 2021; 18(23). Medline
|