Methods of external hemorrhage control at pre-hospital level: Systematic review

Introduction:  Effective and timely control of bleeding is the most important step in the management of seriously injured patients. In recent years, new techniques, devices and drugs have been developed to effectively control pre-hospital bleeding.

Aim: To review the recent international literature on the effectiveness of pre-hospital external hemorrhage control methods in the outcome of patients.

Material and Method: International bibliography was searched for studies published from 01/01/2010 to 31/08/2019 in the PUBMED database. The review included primary studies written in English that focused on the application of methods, techniques and substances to control external bleeding at pre-hospital level.

Results: Α total of 14 review articles were included in the research and selection process.  A small percentage of patients have complications from using tourniquet. The hemostatic dressings, the iTClamp^® and the tranexamic acid (TXA) have been found to be effective in controlling bleeding. The iTClamp^® can be applied very quickly, in less than a minute. At the same time, the TXA was associated with better patient outcomes and fewer units of transfused blood.
Conclusion: The tourniquet, the haemostatic dressings, the iTClamp^® and the TXA help to effectively control haemorrhage at the pre-hospital level and improve patient outcomes, but further investigation is needed.

Keywords: External hemorrhage, external injury, prehospital, tourniquet, hemostatic agents, hemostatic dressings