All patients except one had emergency tourniquet use
that was appropriate. All were aimed at being an arterial
tourniquet except for one patient who had a purposeful
venous tourniquet. This one patient, with open type 3B
tibia and fibula shaft fractures, had a medically indicated
tourniquet used inappropriately as a venous tourniquet in
the ED. The patient also had 40% body surface area
burns. No complications other than blood loss were
attributable to inappropriate tourniquet use, and tourniquet
replacements or corrections were made on the
spot (3).
Misuse occurred in 13 cases, including the patient
described above who had a tourniquet placed on the
wrong limb (Table 3). These problems were addressed
with improved training, device design refinements, and
more device testing and maintenance procedures.