{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:27:24Z","timestamp":1792510044108,"version":"4.5.0"},"reference-count":10,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2007,12]]},"abstract":"\n Aim<\/jats:title>\n To determine the prevalence of tourniquet use in combat trauma, the contribution to lives saved and the complications of their use in this environment.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n All casualties treated at UK field hospital facilities in Iraq and Afghanistan and meeting criteria for entry into UK Joint Theatre Trauma Registry (JTTR) from 04 Feb 03 to 30 Sep 07.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Cases were identified from UK JTTR. Casualties from Permanent Joint Overseas Bases (PJOBs) were excluded. ISS, NISS, TRISS and ASCOT were calculated automatically within JTTR from AIS 2005 (Military) codes. <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 1375 patients met UK JTTR entry criteria for the period specified (excluding PJOBs). 70\/1375 patients (5.1%) were treated with one or more tourniquets (total 107 tourniquet applications). 61\/70 (87%) survived their injuries. 17\/70 (24%) patients had 2 or more tourniquets applied. 64\/70 patients received a tourniquet after April 2006, when tourniquets were introduced as an individual first aid item. 43\/70 (61%) patients were UK military.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n ISS and TRISS are poorly representative of injury severity and outcome for combat trauma involving isolated multiple limb injuries and cannot be used to discriminate whether a tourniquet is life-saving. The presence of severe isolated limb injuries, profound hypovolaemic shock and the requirement for massive transfusion reasonably identifies a cohort where the use of one or more tourniquets pre-hospital to control external bleeding can be said to be life-saving.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/jramc-153-04-19","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:43:32Z","timestamp":1363722212000},"page":"310-313","source":"Crossref","is-referenced-by-count":77,"title":["Tourniquet Use in Combat Trauma: UK Military Experience"],"prefix":"10.1136","volume":"153","author":[{"given":"S","family":"Brodie","sequence":"first","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J","family":"Hodgetts","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Ollerton","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"McLeod","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Lambert","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2007,12,1]]},"reference":[{"key":"ref_1","first-page":"13","article-title":"A profile of combat injury","volume":"54","author":"Champion, H.R.; Bellamy, R.F.; Roberts, P.; Leppaniemi","year":"2003","unstructured":"Champion HR, Bellamy RF, Roberts P, Leppaniemi. A profile of combat injury. J Trauma 2003; 54: S13-S19.","journal-title":"J Trauma"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/emj.2006.039610","article-title":"ABC to : redefining the military trauma paradigm","volume":"23","author":"Hodgetts, T.J.; Mahoney, P.F.; Russell, M.Q.; Byers, M.","year":"2006","unstructured":"Hodgetts TJ, Mahoney PF, Russell MQ, Byers M. ABC to : redefining the military trauma paradigm. Emergency Medicine Journal 2006; 23; 745-746.","journal-title":"Emergency Medicine Journal"},{"key":"ref_3","article-title":"Army Code 71638, 2007 (5e); Battlefield Advanced Trauma Life Support","author":"Drills, Battlefield Casualty","unstructured":"Battlefield Casualty Drills. Army Code 71638, 2007 (5e); Battlefield Advanced Trauma Life Support (2006, 3e), Defence Medical Education and Training Agency, Joint Service Publication 570."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1136\/jramc-153-02-05","article-title":"A realistic model for catastrophic external haemorrhage training","volume":"153","author":"Moorhouse, I.; Thurgood, A.; Walker, N.; Cooper, B.; Mahoney, P.; Hodgetts, T.","year":"2007","unstructured":"Moorhouse I, Thurgood A, Walker N, Cooper B, Mahoney P, Hodgetts T. A realistic model for catastrophic external haemorrhage training. Journal of the Royal Army Medical Corps 2007: 153; 99-101.","journal-title":"Journal of the Royal Army Medical Corps"},{"key":"ref_5","first-page":"77","article-title":"Tourniquet problems in war injuries. Bull US Army Med Dept","volume":"87","author":"Wolff, L.; Adkins, T.","year":"1945","unstructured":"Wolff L, Adkins T. Tourniquet problems in war injuries. Bull US Army Med Dept 1945; 87: 77-84."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/jramc-153-01-03","article-title":"The military tourniquet","volume":"153","author":"Parker, P.; Clasper, J.","year":"2007","unstructured":"Parker P, Clasper J. The military tourniquet. J R Army Med Corps 2007; 153: 10-12.","journal-title":"J R Army Med Corps"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/00005373-198704000-00005","article-title":"Evaluating Trauma Care: The TRISS Method","volume":"27","author":"Boyd, C.R.; Tolson, M.A.; Copes, W.S.","year":"1987","unstructured":"Boyd CR, Tolson MA, Copes WS. Evaluating Trauma Care: The TRISS Method. J Trauma 1987; 27: 370-8.","journal-title":"J Trauma"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1097\/00005373-199005000-00003","article-title":"A New Characterisation of Injury Severity","volume":"30","author":"Champion, H.R.; Copes, W.S.; Sacco, W.J.","year":"1990","unstructured":"Champion HR, Copes WS, Sacco WJ et al. A New Characterisation of Injury Severity. J Trauma 1990; 30: 539-546.","journal-title":"J Trauma"},{"key":"ref_9","article-title":"Battlefield Advanced Trauma Life Support. Joint Service Publication 570, Defence","year":"2005","unstructured":"Battlefield Advanced Trauma Life Support. Joint Service Publication 570, Defence Medical Education Training Agency, 2005.","journal-title":"Medical Education Training Agency"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1136\/bmj.307.6909.906","article-title":"The hit and miss of ISS and TRISS","volume":"307","author":"Zoltie, N.; De Dombal, F.T.","year":"1993","unstructured":"Zoltie N, De Dombal FT. The hit and miss of ISS and TRISS. BMJ 1993; 307: 906-9.","journal-title":"BMJ"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-153-04-19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T19:21:53Z","timestamp":1755112913000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-153-04-19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,12]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2007,12,1]]},"published-print":{"date-parts":[[2007,12]]}},"alternative-id":["10.1136\/jramc-153-04-19"],"URL":"https:\/\/doi.org\/10.1136\/jramc-153-04-19","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,12]]}}}