[Tourniquet use in civil and military medicines]

Abstract

Objectives: The purpose of this literature review is, after a history and a point about current situation, to present the military use and precautions of use of tourniquet for civil and military medicine.

Data sources: A review of the Anglo-Saxon and French literature was performed in PUBMED database, from 1962 to 2012. The research was conducted using the following keywords: "tourniquet", "complications", "haemorrhage", "emergency", "military medicine", used alone or in combination.

Data extraction: The extracted data concerned the history, the epidemiology, the interest of tourniquet during peacetime and wartime, adverse effects and the ratio benefit/risk.

Data synthesis: The tourniquet is "a device which is tightened, in case of haemorrhage, around a limb in order to slow or stop the venous or arterial circulation before surgery…". This item is thus used in surgery to reduce intraoperative bleeding and in emergency medicine as a rescue technique for bleeding places non accessible to compression or to other technical hemostasis. It is also used for treating bleeding of mass casualties. However, its use is too poorly managed by health professionals and it remains risky. Recent armed conflicts have yet revived its day use.

Conclusion: The tourniquet has utility in times of war and in peacetime. In each case, indications and complications must be known.

Keywords: Complications; Effets secondaires; Emergency; Garrot; Haemorrhage; Hémorragie; Military medicine; Médecine d’urgence; Médecine militaire; Tourniquet.