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From the battlefield to main street

Tourniquet acceptance, use, and translation from the military to civilian settings

Goodwin, Tress MD; Moore, Krista N. MD; Pasley, Jason David DO; Troncoso, Ruben Jr MD; Levy, Matthew J. DO; Goolsby, Craig MD

Journal of Trauma and Acute Care Surgery: July 2019 - Volume 87 - Issue 1S - p S35–S39
doi: 10.1097/TA.0000000000002198

ABSTRACT Throughout history, battlefield medicine has led to advancements in civilian trauma care. In the most recent conflicts of Operation Enduring Freedom in Afghanistan/Operation Iraqi Freedom, one of the most important advances is increasing use of point-of-injury hemorrhage control with tourniquets. Tourniquets are gradually gaining acceptance in the civilian medical world—in both the prehospital setting and trauma centers. An analysis of Emergency Medical Services (EMS) data shows an increase of prehospital tourniquet utilization from 0 to nearly 4,000 between 2008 and 2016. Additionally, bystander educational campaigns such as the Stop the Bleed program is expanding, now with over 125,000 trained on tourniquet placement. Because the medical community and the population at large has broader acceptance and training on the use of tourniquets, there is greater potential for saving lives from preventable hemorrhagic deaths.

From the Department of Military and Emergency Medicine, Uniformed Services (T.G., K.N.M., C.G.), University of the Health Sciences, Bethesda, MD; Department of Emergency Medicine (T.G.), Children's National Health System and George Washington University, Washington, DC; Department of Surgery (J.D.P.), Cedars Sinai Medical Center, Los Angeles, CA; Johns Hopkins Department of Emergency Medicine (R.T.Jr., M.J.L.), Baltimore, MD; Department of Fire and Rescue (M.J.L.), Howard County. MD; and National Center for Disaster Medicine & Public Health (C.G.), Rockville, MD.

Address for reprints: Tress Goodwin, MD, Department of Emergency Medicine, Children's National Medical Center, 111 Michigan Ave, NW, Washington, DC 20010; email:

© 2019 Lippincott Williams & Wilkins, Inc.