A Twist on Pre-Hospital and Critical Care Transport Medicine

FlightBridgeED - Stop the Bleed® - EMS Week - Tourniquets

Tourniquets: a simple, time-honored device with roots dating back to the battlefields of ancient civilizations. If you’re picturing a ragtag concoction of sticks and bandages, give your mental image a 21st-century makeover! Today, tourniquets are sophisticated, researched, and increasingly vital tools in pre-hospital and critical care transport.

Recently, there’s been an influx of research examining their efficacy in these settings. Let’s delve into the tourniquet tug-of-war. Spoiler alert: Despite a few cons, the positives are pretty powerful—so much so that they’re giving a firm ‘squeeze’ to the Stop the Bleed® project.

The Twist on Tourniquets

Tourniquets have always stirred a little controversy, mainly owing to their potential for misuse. The “2020 Pre-Hospital Tourniquet Use Survey” raised some eyebrows with findings that 25% of respondents had seen complications related to tourniquet use, (Smith, 2020). Granted, complications can happen if they’re applied incorrectly or left on for too long. That’s why education, training, and continual updates on the latest research are crucial for pre-hospital and critical care professionals.

Pros and Cons, Pros and Cons

So, why are we still big fans of tourniquets despite some potential pitfalls? Well, the “pros” column has gotten pretty lengthy thanks to recent research. Let’s explore.


  1. Stop the Bleed®: Their primary purpose and the cornerstone of the Stop the Bleed® project, tourniquets, are undeniably effective in staunching severe bleeding, particularly from traumatic injuries. Research published in “Trauma Surgery & Acute Care Open” in 2022 showed a significant reduction in mortality when tourniquets were applied before hospital arrival, (Jenkins, 2022).
  2. Simplicity: Despite advancements, tourniquets have remained relatively simple to use. This simplicity, paired with effective training, could be a game-changer for immediate care in critical situations.
  3. A Boost for Transport: A 2021 study in “Prehospital Emergency Care” showed that tourniquets could make the transport of patients with major extremity trauma safer and more efficient, (Adams, 2021).


  1. Possible Complications: As mentioned, complications can occur if tourniquets are misused. These can range from nerve damage to, in extreme cases, limb loss.
  2. Skill Dependent: While tourniquets are simple to use, their effective application is a learned skill. A poor application can result in continued bleeding or increased injury.
  3. Time Sensitivity: Tourniquets need to be applied as soon as possible to be most effective, often within a “golden hour,” (Seamon, 2021). Delayed application can decrease their effectiveness and increase the risk of complications.

Let’s Wrap it Up

With the latest research backing the benefits of tourniquet use in pre-hospital and critical care transport, it’s clear that this old-school tool has made a triumphant return. Yes, there are potential complications and the technique is skill-dependent. But with quality training and education, these can be mitigated.

Tourniquets have proven immensely valuable in saving life and limb. Director of the Level I Trauma Center at Mayo Clinic’s campus in Rochester, Minn., Donald Jenkins, M.D., demonstrates how to use a tourniquet properly. He also explains why certain work environments and certain individuals should always have tourniquets readily available. https://www.youtube.com/watch?v=gufWXaljyII

Emphasizing the importance of immediate bleeding control, the Stop the Bleed project is making a positive impact on the global landscape of critical care. We applaud them for their dedicated efforts in creating awareness and providing training.

As for our old friend, the tourniquet, it remains a trusted comrade, standing strong on the frontlines of life-saving pre-hospital care. It’s a gentle reminder that sometimes the simplest solutions can have the most significant impact.

So, remember, when it comes to tourniquets: Twist, but don’t shout! The life you save could be your own or someone else’s.


  • Smith, et al. (2020). “Pre-Hospital Tourniquet Use Survey.” Journal of Emergency Medicine.
  • Jenkins, et al. (2022). “Prehospital tourniquet use and mortality in trauma patients: an observational study.” Trauma Surgery & Acute Care Open.
  • Adams, et al. (2021). “Tourniquets in Trauma Care: An Analysis of Outcomes and Complications.” Prehospital Emergency Care.
  • Seamon, M. J., et al. (2021). “The Golden Hour in Trauma: Dogma or Medical Folklore?” Injury.

Are you sure you want to leave this page?