Harvard Medical School, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA.
Italian Trauma League ODV, Genoa, Italy.
J Spec Oper Med. 2024 Oct 2;24(3):67-69. doi: 10.55460/60U2-4ATN.
Rapid and effective tourniquet application is crucial in life-threatening limb hemorrhage to minimize mortality. However, the widespread availability of counterfeit tourniquets is a growing concern, as these devices may lack essential quality control measures, potentially compromising patient care. We describe one case where the delayed mechanical failure of a Combat Application Tourniquet (CAT)-like tourniquet caused the death of a Ukrainian soldier during evacuation to an urban trauma center. In April 2022, a 19-year-old male underwent a bilateral below-the-knee amputation from an antipersonnel landmine. Massive hemorrhage prompted the use of bilateral CAT-like tourniquets. During transportation, the right tourniquet's windlass broke, resulting in a brisk hemorrhage. Due to the high patient-to-healthcare-personnel ratio, the bleeding remained unaddressed for an unknown amount of time, resulting in death from hemorrhagic shock. This study underscores the need for robust quality control measures and the establishment of strict regulations against deploying counterfeit tourniquets to avoid preventable deaths.
快速有效地应用止血带对于控制危及生命的肢体大出血至关重要，可以最大限度地降低死亡率。然而，假冒止血带的广泛存在是一个日益令人担忧的问题，因为这些设备可能缺乏必要的质量控制措施，从而可能影响患者的治疗效果。我们描述了一个案例，在将一名乌克兰士兵转移到城市创伤中心的过程中，由于军用快速止血带（CAT 样止血带）的机械延迟失效，导致这名士兵死亡。2022 年 4 月，一名 19 岁男性因触雷导致双侧小腿以下截肢。大量出血促使使用双侧 CAT 样止血带。在运输过程中，右侧止血带的绞盘断裂，导致迅速出血。由于患者与医护人员的比例很高，出血在未知的时间内未得到处理，最终因失血性休克而死亡。本研究强调了需要采取严格的质量控制措施，并制定严格的规定来防止使用假冒止血带，以避免可预防的死亡。
