Guo Jun-Yan, Liu Yu, Ma Yan-Lan, Pi Hong-Ying, Wang Jian-Rong
Department of Nursing, General Hospital of PLA, Beijing 100853, China.
Chin J Traumatol. 2011 Jun 1;14(3):151-5.
Massive hemorrhage is life-threatening during armed conflicts. Tourniquets are important medical devices used to reduce severe bleeding in trauma. The aim of this study was to empirically evaluate the current tourniquets used in China and provide information to emergency nurses in selecting the appropriate tourniquet.
Five tourniquets were self-applied by 20 healthy participants. The blood flow distal to the tourniquet site was assessed using vascular Doppler ultrasound. Application time, pain, numbness, and other parameters were evaluated.
The bladder tourniquet and windlass tourniquet effectively occluded arterial blood flow with success rates higher than 75% in both the upper and lower extremities. The Cargo-strap was the fastest to apply, taking (7.22+/-2.30) s for the upper extremity and (6.48+/-2.40) s for the lower extremity. The rubber tube was the most painful, and the improvised tourniquet was the least efficient. The success rates were higher in the lower extremity than in the upper extremity (P less than 0.05, X(2) equal to 5.714).
The bladder tourniquet and the windlass tourniquet are efficient tourniquets, although the windlass is superior with respect to portability and pain. The Cargo-strap and rubber tourniquets have several disadvantages that reduce their suitability for field use. The improvised tourniquet is not recommended because of low efficiency and severe pain during implementation.
在武装冲突期间，大出血会危及生命。止血带是用于减少创伤中严重出血的重要医疗设备。本研究的目的是对中国目前使用的止血带进行实证评估，并为急诊护士选择合适的止血带提供信息。
20名健康参与者自行使用五种止血带。使用血管多普勒超声评估止血带部位远端的血流情况。评估应用时间、疼痛、麻木及其他参数。
气囊止血带和绞盘式止血带能有效阻断动脉血流，在上肢和下肢的成功率均高于75%。货物绑带应用速度最快，上肢用时（7.22±2.30）秒，下肢用时（6.48±2.40）秒。橡胶管最疼，简易止血带效率最低。下肢的成功率高于上肢（P＜0.05，X² = 5.714）。
气囊止血带和绞盘式止血带是有效的止血带，尽管绞盘式止血带在便携性和疼痛方面更具优势。货物绑带和橡胶止血带有几个缺点，降低了它们在野外使用的适用性。不建议使用简易止血带，因为其效率低且实施过程中疼痛剧烈。
