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Emergencias 2019 31 1 47 54 eng Copy

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Emergencias 2019;31:47-54 REVIEW ARTICLE Tourniquet use in out-of-hospital emergency care: a systematic review Mara Alonso-Algarabel1, Xavier Esteban-Sebastià2, Azucena Santillán-García3, Rafael Vila-Candel4,5 Objective. Uncontrolled bleeding from serious injuries continues to be one of the main causes of preventable deaths outside hospitals. Tourniquets could be useful for quickly stemming blood flow and prevent exsanguination, although evidence supporting their use and effectiveness in civilian accidents is limited. To analyze the effectiveness of tourniquets for stopping bleeding in out-of-hospital emergencies and to explore factors associated with effectiveness. Methods. We undertook a systematic review of the literature in Spanish and English. Search protocols to identify studies that evaluated the use of various devices and their effectiveness in stemming arterial blood flow. We included studies published between 2011 and 2016 in which tourniquets were used to prevent massive blood loss. Results. We included 17 articles. Tourniquets were effective in stopping massive bleeding in all studies. Pain, the most frequently described adverse effect, was observed in 420 patients (35.7%). Delayed application of a tourniquet was associated with more negative outcomes. Conclusions. Tourniquets are effective for stopping massive blood loss. There are few complications, most of which are attributable to the critical state of patients rather than to application of the tourniquet ...
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