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Survey of trauma registry data on tourniquet use in pediatric war casualties.
Kragh, John F; Cooper, Arthur; Aden, James K; Dubick, Michael A; Baer, David G; Wade, Charles E; Blackbourne, Lorne H.
Afiliação
  • Kragh JF; US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-6315, USA. john.kragh1@us.army.mil
Pediatr Emerg Care ; 28(12): 1361-5, 2012 Dec.
Article em En | MEDLINE | ID: mdl-23187998
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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Torniquetes / Guerra / Ferimentos e Lesões / Sistema de Registros / Pesquisas sobre Atenção à Saúde / Emergências / Incidentes com Feridos em Massa / Hemorragia / Hospitais Militares Tipo de estudo: Etiology_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Torniquetes / Guerra / Ferimentos e Lesões / Sistema de Registros / Pesquisas sobre Atenção à Saúde / Emergências / Incidentes com Feridos em Massa / Hemorragia / Hospitais Militares Tipo de estudo: Etiology_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2012 Tipo de documento: Article