Combat lifesaver-trained, first-responder application of junctional tourniquets: A prospective, randomized,crossover trial

作     者：Ismael Flecha Jason FNaylor Steven GSchauer Ryan ACurtis Cord WCunningham 

作者机构：21st Combat Support HospitalFort HoodKilleen76544TXUSA Madigan Army Medical CenterJBLM Fort LewisLakewood98431USA San Antonio Military Medical CenterJBSA Fort Sam HoustonSan Antonio78234TXUSA US Army Institute of Surgical ResearchJBSA Fort Sam HoustonSan Antonio78234TXUSA 59th MedicalWingJBSA LacklandSan Antonio78234TXUSA 

出 版 物：《Military Medical Research》 (军事医学研究（英文版）)

年 卷 期：2019年第6卷第2期

页      面：105-110页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：The authors declare that they did not receive any funding equipment or supplies for the conduct of this current study 

主　　题：Junctional Tourniquet Hemorrhage Combat Battlefield 

摘      要：Background:Junctional hemorrhage surpassed extremity hemorrhage as the leading cause of preventable death after the resurgence of limb tourniquets during the recent conflicts in Afghanistan and *** tourniquets(JTQs)were developed in response to this injury *** data for JTQ efficacy are limited and do not incorporate nonmedical,military first *** compared the time for effective placement and scores for device satisfaction between two different JTQs,stratified by combat lifesaver(CLS)and combat ***:We performed a prospective,randomized,crossover trial utilizing the SAM ’ Medical Junctional Tourniquet(SJT)and Junctional Emergency Treatment Tool(JETTTM).Investigators simple randomized CLS and combat medics to SJT or JETT for their first JTQ application on mannequins with penetrating inguinal ***,participants immediately placed the other JTQ on another casualty with the same *** primary outcome measured was time of successful applicatio *** was defined as proper JTQ placement and a pressu re reading of at least 180 *** compared outcomes between CLS and combat *** JTQ applications were excluded from the comparative ***:From June 2015 to August 2015,a total of 227 personnel(133 CLS and 94 combat medics)at Fort Hood,Texas,USA volunteered to participate in the ***-eight percent(38 of 133)of CLS and 40%(38 of 94)of combat medics placed both JTQs successfully,for a total of 152 applications(76 SJTs and 76 JETTs).We found a significant difference between applications of the JETT between the CLS and combat medics(92.0±37.7 s versus70.5±20.5 s,P=0.004).No other subg roup analyses,whether by device or user,demonstrated a sig nifica nt difference in application *** groups preferred the SJT over the *** disagreed with combat medics that the JETT could be easily applied by one person(median 3.0[2.0,4.0]versus median 4.0[3.0,5.0];P=0.006).Conclusions:Overall,succe