Childers Richard, Tolentino Jerlyn C, Leasiolagi John, Wiley Nick, Liebhardt Damian, Barbabella Sean, Kragh John F
Naval Hospital Camp Pendleton, H100 Santa Margarita Road, Oceanside, CA 92058, USA.
Mil Med. 2011 Dec;176(12):1400-3. doi: 10.7205/milmed-d-11-00212.
We hypothesize that an anecdotally observed increase in tourniquet breakage and decrease in efficacy may be secondary to environmental exposure during military deployment. This was a study comparing efficacy and breakage of 166 Afghanistan-exposed tourniquets to 166 unexposed tourniquets. Afghanistan exposure was defined as tourniquet carriage by field staff in the operational environment for approximately 6 months. In a controlled environment in the United States, a previously exposed tourniquet was tested on one thigh of each subject, while an unexposed tourniquet was tested on the opposite thigh. We recorded tourniquet efficacy (absence of distal pedal pulse for at least 30 seconds), breakage, and the number of turns required to stop the distal pedal pulse. A Wilcoxon sign-rank test was used to test differences between exposed and unexposed tourniquets. Tourniquets exposed to the environment broke more often (14/166 versus 0/166) and had decreased efficacy (63% versus 91%; p < 0.001). Three turns were required for most tourniquets to be efficacious. Environmental exposure of military tourniquets is associated with decreased efficacy and increased breakage. In most cases, tourniquets require three turns to stop the distal lower extremity pulse.
我们推测，坊间观察到的止血带破损增加及效能降低现象，可能是军事部署期间环境暴露所致。本研究比较了166条曾在阿富汗使用过的止血带与166条未使用过的止血带的效能和破损情况。曾在阿富汗使用的定义为野外工作人员在作战环境中携带止血带约6个月。在美国的一个受控环境中，在每个受试者的一条大腿上测试一条曾使用过的止血带，而在另一条大腿上测试一条未使用过的止血带。我们记录了止血带的效能（至少30秒无足背动脉搏动）、破损情况以及阻断足背动脉搏动所需的缠绕圈数。采用Wilcoxon符号秩和检验来测试曾使用过的止血带与未使用过的止血带之间的差异。暴露于环境中的止血带破损更为频繁（14/166对比0/166）且效能降低（63%对比91%；p<0.001）。大多数止血带需要缠绕三圈才能有效。军事止血带的环境暴露与效能降低和破损增加有关。在大多数情况下，止血带需要缠绕三圈才能阻断下肢远端脉搏。
