The 50 original articles included in this qualitative , systematic review revealed that the recommendations " Tourniquet " of the DGAI published in 2016 are mostly still up to date despite an inhomogeneous study situation .
INTRODUCTION The effectiveness of a  tourniquet  in the case of life-threatening hemorrhages of the extremities is well recognized and led to the recommendations on " Tourniquet " of the German Society of Anaesthesiology and Intensive Care ( DGAI ) in 2016 .
The aim of this systematic review was to re-evaluate the current medical literature in relation to the published DGAI recommendations .
Randomised controlled trial comparing marksmanship following application of a tourniquet or haemostatic clamp in healthy volunteers
Background In a care under fire situation , a first line response to haemorrhage is to apply a tourniquet and return fire . However , there is little underst and ing of how tourniquets and other haemorrhage control devices impact marksmanship . Methods We compared the impact of the iTClamp and the Combat Application Tourniquet ( CAT ) on marksmanship . Following r and omisation ( iTClamp or CAT ) , trained marksmen fired an AR15 at a scaled silhouette target in prone unsupported position ( shooting task ) . Subjects then attempted to complete the shooting task at 5 , 10 , 15 , 30 and 60 min post-haemorrhage control device application . Results All of the clamp groups ( n=7 ) completed the 60 min shooting task . Five CAT groups ( n=6 ) completed the 5 min shooting task and one completed the 5 and 10 min shooting task before withdrawing . Four CAT groups were stopped due to unsafe h and ling ; two stopped due to pain . When examining hits on mass ( HOM ) for the entire shooting task , there was no significant difference between tourniquet and iTClamp HOM at 5 min ( p=0.18 ) . However , there was a significant difference at 10 min , p=0.003 with tourniquet having significantly fewer HOM ( 1.7±2.7 HOM ) than the iTClamp ( 8.1±3.3 HOM ) group . The total effective HOM for the entire 60 min shooting task showed that the iTClamp group achieved significantly ( p=0.001 ) more HOM than the tourniquet group . Over the entire 60 min shooting exercise , the iTClamp group achieved a median 72 % ( 52/72 ) of available HOM while the tourniquet group obtained 19 % ( 14/72 ) . Conclusions Application of a tourniquet to the dominant arm negates effective return of fire in a care under fire setting after a brief time window . Haemorrhage control devices that preserve function may have a role in care under fire situations , as preserving effectiveness in returning fire has obvious operational merits
The 50 original articles included in this qualitative , systematic review revealed that the recommendations " Tourniquet " of the DGAI published in 2016 are mostly still up to date despite an inhomogeneous study situation .
INTRODUCTION The effectiveness of a  tourniquet  in the case of life-threatening hemorrhages of the extremities is well recognized and led to the recommendations on " Tourniquet " of the German Society of Anaesthesiology and Intensive Care ( DGAI ) in 2016 .
The aim of this systematic review was to re-evaluate the current medical literature in relation to the published DGAI recommendations .