Ten patients who came to our hospital during the study
period had isolated limb exsanguination amenable to
tourniquet application, but tourniquets were either ununavailable
(none at scene), inaccessible (packed away and
found after the patient died), or not placed in time after
extrication from vehicles or after transport before the
patient died. Cause of death in all 10 patients was exsanguination
from limb injuries. In contrast to the 10
casualties without tourniquets, in the 499 casualties with
tourniquets, 16 of the 65 deaths were from isolated limb
exsanguination, often with tourniquets placed after shock
onset (19 had severe [AIS 3 to 6] head wounds, 15 had
severe abdominal wounds, 7 had severe chest wounds, 4
had severe burns, and 2 had two or more equally severe
body regions injured). From the 10 patients without
tourniquets (0% survival) and the 499 with tourniquets
(87% survival), we measured the mortality rate of patients
who exsanguinated from isolated limb injuries at
2% (10/519)