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 .
Analysis of Layperson Tourniquet Application Using a Novel Color-Coded Device.
OBJECTIVE To determine whether a color-coded tourniquet design ed for public use increases successful tourniquet application by laypeople . METHODS This was a r and omized study conducted on April 25 , 2015 . The study occurred during the Maryl and Day activity at the University of Maryl and in College Park , Maryl and . Investigators recruited participants with posters displayed at major crosswalks around a central testing area . A total of 157 volunteers aged 18 years or older and without prior military service or medical training were enrolled . A participant stood in front of a waist-down mannequin with an isolated leg injury while an investigator read aloud a mass causality scenario . The investigator then asked the participant to apply a tourniquet to the mannequin 's leg . All participants received a 4-step illustrated just-in-time ( JiT ) instruction card design ed to facilitate layperson tourniquet application . Test participants received a color-coded tourniquet design ed for layperson use with instructions printed on the device . Control participants received a black Combat Application Tourniquet ( C-A-T ; Composite Re sources , Rock Hill , SC ) . Participants were r and omized in a 1:1 ratio in blocks of 50 . The primary outcome was the proportion of successful tourniquet applications by those who received color-coded tourniquets compared to those who received black tourniquets . Secondary outcomes included validation of previous data analyzing layperson success with tourniquet application , time for successful placement , reasons for failed applications , and participant self-willingness and comfort using tourniquets . We also analyzed demographic data on the study population and inter-rater reliability regarding the assessment of successful tourniquet application . RESULTS Participants supplied with color-coded tourniquets  successfully placed the device 51.38 % of the time , compared to 44.71 % of the time for controls using a black tourniquet ( risk ratio : 1.15 ; 95 % confidence interval : 0.83 - 1.59 ; P=0.404 ) . Participants  ' self-reported willingness to use a tourniquet rose from 40.8 % before the study to 80.3 % after the study ( P<0.05 ) . CONCLUSIONS The color-coded device did not significantly increase laypeople 's proportion of successful tourniquet applications when compared with a st and ard black device . However , this study reproduced pilot study data showing that laypeople can successfully apply tourniquets about half the time if provided JiT instructions . Age , sex , race , income , and highest level of education were not found to impact one 's ability to properly apply a tourniquet . Laypeople 's willingness to apply tourniquets doubled to 80 % after brief exposure to the device . These results affirm the feasibility of engaging laypeople as immediate lifesavers of trauma victims and justify further efforts to boost rates of proper application
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 .