title: The iTClamp in the management of prehospital haemorrhage.
abstract: BACKGROUND
  Bleeding remains a leading cause of death in trauma patients. The iTClamp is a temporary wound closure device designed to control external bleeding within seconds of injury. We describe our experience using this device on 10 patients in the prehospital environment.
  
  
  METHODS
  We have implemented the iTClamp for prehospital use through our physician-staffed helicopter emergency medical service (HEMS). Indications were massive bleeding that could not be controlled with an ordinary compressive bandage or a haemostatic bandage.
  
  
  RESULTS
  Ten patients were treated with the iTClamp. Seven patients had a severe head injury due to various traumas, one patient had a neck injury from a disk cutter, one patient had an open chest wound and one patient had an open femur fracture. After applying the iTClamp, bleeding was controlled in 90% of these patients (n=9), with complete cessation reported in 60% (n=6), partial cessation with adequate control reported in 30% (n=3); in one patient, the bleeding could not be controlled with the iTClamp alone. It took an average of 10s to apply the iTClamp, and the average usage satisfaction score was 7.7.
  
  
  CONCLUSIONS
  We conclude that the iTClamp is a safe, fast and useful tool for stopping or controlling external blood loss in our series of prehospital patients. Further studies of the iTClamp are needed to determine which patients might benefit from this device.
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: edward.tan@radboudumc.nl.
authors.forename: Edward C T H
authors.initials: EC
authors.lastname: Tan
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Joost H
authors.initials: JH
authors.lastname: Peters
authors.affiliation: Innovative Trauma Care, Suite 343, 6556-28 Ave, Edmonton, AB, Canada T6L 6N3.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Mckee
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Michael J R
authors.initials: MJ
authors.lastname: Edwards
mesh_terms: D000328:Adult; D017732:Air Ambulances; D004632:Emergency Medical Services / Q000379:methods; D058734:Exsanguination / Q000517:prevention & control*; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control* / Q000628:therapy; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications / Q000628:therapy*
keywords: Haemorrhage; Haemorrhage control; Penetrating injury