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Randomized Controlled Trial
. 2021 Apr 1;90(4):666-672.
doi: 10.1097/TA.0000000000003055.

Tourniquet application by schoolchildren-a randomized crossover study of three commercially available models

Alaa El Bashtaly  1 , Elene Khalil, Francois Méthot, Lawrence Ledoux-Hutchinson, Jeffrey M Franc, Valérie Homier
Affiliations
Randomized Controlled Trial

Tourniquet application by schoolchildren-a randomized crossover study of three commercially available models

Alaa El Bashtaly et al. J Trauma Acute Care Surg. .

Abstract

Background: Life-threatening hemorrhage is a major cause of preventable mortality in trauma. Studies have demonstrated the effectiveness and safety of commercial tourniquets when used by adult civilians. However, there are no data about tourniquet application by children.This study's goal is to determine which of three commercially available tourniquets is most effective when used by children.

Methods: A randomized crossover study was conducted in four elementary schools in Montreal to compare three commercially available tourniquets. The study population is primary school children aged 10 to 12 years (5th-6th grade). A total of 181 students were invited to participate; 96 obtained parental approval and were recruited. Participants underwent a short 7-minute video training on the use of three commercial tourniquets and were subsequently given a 2-minute practice period. Students were evaluated on their ability to successfully apply the tourniquet and the time to complete application. After applying all three tourniquets, the students selected their favorite model. The primary outcome is the proportion of successful applications per tourniquet model. Secondary outcomes include time to successful application for each tourniquet model and tourniquet model preference.

Results: The mechanical advantage tourniquet (MAT) outperformed the combat application tourniquet (CAT) and the stretch wrap and tuck tourniquet (SWATT) in terms of success rate (MAT, 67%; CAT, 44%; SWATT, 24%; p < 0.0001), time to application (MAT, 57 seconds; CAT, 80 seconds; SWATT, 90 seconds; p < 0.0001), and preference (MAT, 64%; CAT, 30%; SWATT, 6%; p < 0.0001).

Conclusion: In this study, the MAT performs better in terms of success rate, time to application, and preference when used by school-aged children. This study can be helpful when facilities are purchasing tourniquets for use by students.

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References

    1. Oyeniyi BT, Fox EE, Scerbo M, Tomasek JS, Wade CE, Holcomb JB. Trends in 1029 trauma deaths at a level 1 trauma center: impact of a bleeding control bundle of care. Injury . 2017;48(1):5–12.
    1. Sise RG, Calvo RY, Spain DA, Weiser TG, Staudenmayer KL. The epidemiology of trauma-related mortality in the United States from 2002 to 2010. J Trauma Acute Care Surg . 2014;76(4):913–919; discussion 20.
    1. Teixeira PGR, Brown CVR, Emigh 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.e1.
    1. Scerbo MH, Holcomb JB, Taub E, Gates K, Love JD, Wade CE, Cotton BA. The trauma center is too late: major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. J Trauma Acute Care Surg . 2017;83(6):1165–1172.
    1. Goolsby C, Strauss-Riggs K, Rozenfeld M, Charlton N, Goralnick E, Peleg K, Levy MJ, Davis T, Hurst N. Equipping public spaces to facilitate rapid point-of-injury hemorrhage control after mass casualty. Am J Public Health . 2019;109(2):236–241.

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