title: Application of current hemorrhage control techniques for backcountry care: part one, tourniquets and hemorrhage control adjuncts.
abstract: Decade-long advancements in battlefield medicine have revolutionized the treatment of traumatic hemorrhage and have led to a significant reduction in mortality. Older methods such as limb elevation and pressure points are no longer recommended. Tourniquets have had a profound effect on lives saved without the commonly feared safety issues that have made them controversial. Unique tourniquet designs for inguinal and abdominal regions are now available for areas not amenable to current fielded extremity tourniquets. This article, the first of two parts, reviews the literature for advancements in prehospital hemorrhage control for any provider in the austere setting. It emphasizes the significant evidence-based advances in tourniquet use on the extremities that have occurred in battlefield trauma medicine since 2001 and reviews the newer junctional tourniquet devices. Recommendations are made for equipment and techniques for controlling hemorrhage in the wilderness setting.
authors.affiliation: Emergency Medicine Department, Naval Medical Center San Diego, San Diego, CA (Dr Drew).
authors.forename: Brendon
authors.initials: B
authors.lastname: Drew
authors.affiliation: Military and Emergency Medicine Department, Uniformed Services University of the Health Sciences, F. Hébert School of Medicine, Bethesda, MD (Dr Bennett). Electronic address: brad@wms.org.
authors.forename: Brad L
authors.initials: BL
authors.lastname: Bennett
authors.affiliation: Emergency Medicine Department, Naval Medical Center Portsmouth, Portsmouth, VA (Dr Littlejohn).
authors.forename: Lanny
authors.initials: L
authors.lastname: Littlejohn
mesh_terms: D005392:First Aid / Q000379:methods*; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D014111:Tourniquets; D055813:Wilderness Medicine / Q000379:methods; D014947:Wounds and Injuries / Q000628:therapy*
keywords: bandage; dressing; hemorrhage; hemostasis; hemostatic agents; prehospital; topical; tourniquet; trauma