Pediatric Extremity Hemorrhage and Tourniquet Use

It’s two o’clock in the afternoon on a busy Monday. As the radio alerts you, your stomach sinks to your feet: You’ve just been dispatched to a school shooting. The estimated casualty count: 28 persons; ages 5–46 years. As your adrenaline surges, a flurry of thoughts race through your mind: “Sarah is 4-years-old, we were planning to enroll her in that school this fall.” “Are my friends’ children safe?” “Do I have enough pressure dressings and tourniquets?” “Will my commercial tourniquets even work on small children?” The Gun Violence Archive reports that, in 2017, 346 active shooter incidents resulted in the deaths of 437 individuals—the deadliest year in American history.1 A Federal Bureau of Investigation meta-analysis of active shooter incidents (160 incidents, 2000–2013), has shown an average initial incident time frame of less than or equal to 5 minutes.2 These findings demonstrate the extreme importance of an immediate, well-prepared mass casualty response on behalf first responders, law enforcement and emergency services personnel. From Jan. 1 to March 20, 2018, 10 shootings have taken place on school grounds.1 Although shooters are often indiscriminate in their choice of targets, these facts and pervasive discussion make it necessary to revisit published evidence regarding the use of commercial tourniquets for the control of pediatric extremity hemorrhage. In addition to detailing tourniquet specifications, this article further offers heal...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Trauma Exclusive Articles Source Type: news