Tourniquet use in different emergency medicine professional groups, results from a regional cross-sectional online survey.

چکیده اصلی

BACKGROUND: Traumatic haemorrhage is one of the most common causes of death in patients with injuries. Targeted pre-hospital haemostasis can reduce morbidity and mortality. The use of tourniquets is advisable for external bleeding in the extremities that cannot be treated with compression or wound packing. There are recommendations for the use of tourniquets. Little is currently known about the level of training and frequency of use of various professional groups of potential tourniquet users. METHODS: A regional cross-sectional online survey was conducted on the level of training, frequency of use, and adherence to guidelines for tourniquets among various pre-hospital professional groups (emergency medical technician- EMT, advanced emergency medical technician-AEMT, Paramedical, Helicopter Emergency Medical Services-Technical Crew member-HEMS-TC, pre-hospital physician), to get a regional convenience sample. To obtain an overview of the level of training and use of tourniquets among various professional groups, we conducted a regional online survey on ground-based emergency medical services in the region of Halle/Northern Saale District in Saxony-Anhalt, as well as on helicopter emergency medical services in the Halle/Leipzig metropolitan region. The different professional groups were compared with regard to theoretical and practical training, frequency of use, and adherence to the existing guidelines. RESULTS: 178 participants (74% male, 26% female) took part and answered the questionnaire. Among respondents who reported professional group were 47% pre-hospital physicians, 32% paramedics, 9% EMT, 7% HEMS-TCs, 4% AEMT. Statistically significant differences were found in theoretical education, with the lowest rate of education in the EMT group (67%) and the highest rate in the paramedic group (96%). When comparing theoretical education of all the emergency medical service personnel (91%) against the pre-hospital physicians (73%), it was significantly higher in the emergency medical service personnel group. No differences were found in practical training or frequency of use. Physicians had a significant higher adherence to the guidelines for location for applying a tourniquet. CONCLUSION: In addition to theoretical education, no statistically significant differences were detected in this regional sample in terms of practical training or frequency of use. With regard to adherence to existing guidelines, physicians had a significantly higher adherence for location for applying a tourniquet. Standardized training and periodic refresher education may help ensure consistent tourniquet knowledge and application across prehospital professional groups.

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