Tourniquet use in different emergency medicine professional groups. Are there differences in theoretical and practical training, frequency of use, and adherence to existing guidelines?

Background Traumatic haemorrhage is one of the most common causes of death in injured patients. Targeted pre-hospital haemostasis can reduce morbidity and mortality. The use of tourniquets is advisable for external bleeding in the extremities that cannot be treated by compression and wound packing. There are corresponding recommendations for tourniquet use. Little is currently known about the level of training and the frequency of use of the various professional groups of potential tourniquet users. Methods Status survey on the level of training and frequency of use of tourniquets among various pre-hospital professional groups (Emergency Medical Technician / basic emergency medical technicians – EMT, Advanced Emergency Medical Technician / intermediate emergency medical technicians - AEMT, Paramedic / paramedic emergency medical technicians, Helicopter Emergency Medical Services-Technical Crew member - HEMS-TC, Prehospital Physician). In order to obtain an overview of the level of training and use of tourniquets among the various professional groups, we conducted a regional online survey in the ground-based emergency medical services in the region of Halle/Northern Saale District in Saxony-Anhalt, as well as for the helicopter emergency medical services in the Halle/Leipzig metropolitan region. The different professional groups were compared with regard to theoretical and practical training, frequency of use, and adherence to existing guidelines. Results 178 participants (74% male, 26% female) took part and answered the questionnaire, including 47% pre-hospital physician, 32% paramedic, 9% EMT, 8% HEMS-TC, 6% AEMT. The only statistically significant differences were found in theoretical education, with the lowest rate of education in the EMT group (67%) and the highest rate in the paramedic group (96%). When comparing theoretical education of all the emergency medical service personnel (91%) against the pre-hospital physicians (73%), it was significantly higher in the emergency medical service personnel group. No differences were found for practical training, frequency of use, and adherence to existing guidelines. Conclusion Apart from theoretical education, no differences are apparent regarding practical training, frequency of use, and adherence to existing guidelines for potential pre-hospital tourniquet users. However, education and training can still be improved.