title: Evaluation of emergency tourniquets for prehospital use in China.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Nursing, General Hospital of PLA, Beijing 100853, China.
authors.forename: Jun-Yan
authors.initials: JY
authors.lastname: Guo
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Yan-Lan
authors.initials: YL
authors.lastname: Ma
authors.forename: Hong-Ying
authors.initials: HY
authors.lastname: Pi
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Wang
mesh_terms: D000328:Adult; D002681:China; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D014111:Tourniquets