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Pediatric Emergency Care:
doi: 10.1097/PEC.0b013e318276c260
Original Articles

Survey of Trauma Registry Data on Tourniquet Use in Pediatric War Casualties

Kragh, John F. Jr MD*†; Cooper, Arthur MD, MS; Aden, James K. PhD*; Dubick, Michael A. PhD*; Baer, David G. PhD*; Wade, Charles E. PhD§; Blackbourne, Lorne H. MD, MC, USA*

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Abstract

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.

© 2012 Lippincott Williams & Wilkins, Inc.

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