Gestione non farmacologica delle emorragie nel setting pre-ospedaliero

Ricevuto: 21 ottobre 2020
Accettato: 21 ottobre 2020
Pubblicato: 22 ottobre 2020
Abstract Views: 470
PDF: 60
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


L’emorragia esterna continua ad essere una grande sfida nel setting pre-ospedaliero perché spesso di difficile gestione. Essa è generalmente dovuta a traumi e se non controllata numerose possono essere le complicanze che determina. A tal proposito sono stati ideati diversi presidi che hanno come obiettivo il controllo precoce dell’emorragia e quindi la sopravvivenza del paziente. L’obiettivo di questo studio è indagare sui metodi non farmacologici per trattare le emorragie in ambito pre-ospedaliero da parte dell’infermiere di emergenza territoriale



PlumX Metrics


I dati di download non sono ancora disponibili.


Boulton AJ, Lewis CT, Naumann DN, Midwinter MJ. Prehospital haemostatic dressings for trauma: a systematic review. Emerg Med J. 2018 Jul;35(7):449–57.
Kauvar DS, Lefering R, Wade CE. Impact of hemorrhage on trauma outcome: An overview of epidemiology, clinical presentations, and therapeutic considerations. J Trauma - Inj Infect Crit Care. 2006;60(6 SUPPL.):3–11.
Hickman DA, Pawlowski CL, Sekhon UDS, Marks J. Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding. 2017;1700859:1–40.
Michelle HS, Jacob PM, Keith G, Joseph DL, Charles EW, John BH, Bryan AC. Safety and Appropriateness of Tourniquets in 105 Civilians. Prehosp Emerg Care. 2016; 20(6):712-722.
Huei TJ, Mohamad Y, Lip HTC, Noh NM, Alwi RI. Prognostic predictors of early mortality from exsanguination in adult trauma: A Malaysian trauma center experience. Trauma Surg Acute Care Open. 2017;2(1):1–5.
Day MW. Control of traumatic extremity hemorrhage. Crit Care Nurse. 2016;36(1):40–51.
Guven HE. Topical hemostatics for bleeding control in pre-hospital setting: Then and now. Ulus Travma Acil Cerrahi Derg. 2017 Sep;23(5):357–61.
Grissom TE, Fang R. Topical hemostatic agents and dressings in the prehospital setting. Curr Opin Anaesthesiol. 2015 Apr;28(2):210–6.
Grant MJ, Booth A. A typology of reviews: An analysis of 14 review types and associated methodologies. Health Info Libr J. 2009;26(2):91–108.
Tanaka KA, Bolliger D, Guzzetta NA. Clinical and Practical Aspects of Restoring Thrombin Generation in Acute Coagulopathic Bleeding. Vol. 124, Anesthesia and analgesia. United States; 2017. p. 701.
Smith IM, Crombie N, Bishop JR, McLaughlin A, Naumann DN, Herbert M, et al. RePHILL: protocol for a randomised controlled trial of pre-hospital blood product resuscitation for trauma. Transfus Med. 2018 Oct;28(5):346–56.
Bennett BL. Bleeding Control Using Hemostatic Dressings: Lessons Learned. Wilderness Environ Med. 2017 Jun;28(2S):S39–49.
Butler FK, Bennett B, Wedmore CI. Tactical Combat Casualty Care and Wilderness Medicine: Advancing Trauma Care in Austere Environments. Emerg Med Clin North Am. 2017 May;35(2):391–407.
Littlejohn L, Bennett BL, Drew B. Application of current hemorrhage control techniques for backcountry care: part two, hemostatic dressings and other adjuncts. Wilderness Environ Med. 2015 Jun;26(2):246–54.
Drew B, Bennett BL, Littlejohn L. Application of current hemorrhage control techniques for backcountry care: part one, tourniquets and hemorrhage control adjuncts. Wilderness Environ Med. 2015 Jun;26(2):236–45.
Chang R, Eastridge BJ, Holcomb JB. Remote Damage Control Resuscitation in Austere Environments. Wilderness Environ Med. 2017 Jun;28(2S):S124–34.
Khan MA, Mujahid M. A review on recent advances in chitosan based composite for hemostatic dressings. Int J Biol Macromol. 2019 Mar;124:138–47.
Kragh JFJ, Dubick MA. Bleeding Control With Limb Tourniquet Use in the Wilderness Setting: Review of Science. Wilderness Environ Med. 2017 Jun;28(2S):S25–32.
Lier H, Bernhard M, Knapp J, Buschmann C, Bretschneider I, Hossfeld B. [Approaches to pre-hospital bleeding management : Current overview on civilian emergency medicine]. Anaesthesist. 2017 Nov;66(11):867–78.
Kauvar DS, Dubick MA, Walters TJ, Kragh JFJ. Systematic review of prehospital tourniquet use in civilian limb trauma. J Trauma Acute Care Surg. 2018 May;84(5):819–25.
Kluj P, Aleksandrowicz D, Machala W, Gaszynski T. [Advanced methods of prehospital bleeding management based on the experience and standards of tactical medicine]. Pol Merkur Lekarski. 2015 Sep;39(231):186–90.
Hawk AJ. How hemorrhage control became common sense. J Trauma Acute Care Surg. 2018 Jul;85(1S Suppl 2):S13–7.
Blix SW, Melau J, Lund-Kordahl I. Performance of Norwegian civilian EMTs and army medics in penetrating trauma: a controlled simulation-based assessment. Acta Anaesthesiol Scand. 2017 Aug;61(7):848–53.
Mckee JL, Lakshminarasimhan P, Atkinson I, LaPorta AJ, Kirkpatrick AW. Evaluation of Skin Damage from Accidental Removal of a Hemostatic Wound Clamp (The iTClamp). Prehosp Disaster Med. 2017 Dec;32(6):651–6.
Ramly E, Runyan G, King DR. The state of the union: Nationwide absence of uniform guidelines for the prehospital use of tourniquets to control extremity exsanguination. J Trauma Acute Care Surg. 2016 May;80(5):787–91.
Kue RC, Temin ES, Weiner SG, Gates J, Coleman MH, Fisher J, et al. Tourniquet Use in a Civilian Emergency Medical Services Setting: A Descriptive Analysis of the Boston EMS Experience. Prehospital Emerg care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2015;19(3):399–404.
Travers S, Lefort H, Ramdani E, Lemoine S, Jost D, Bignand M, et al. Hemostatic dressings in civil prehospital practice: 30 uses of QuikClot Combat Gauze. Eur J Emerg Med. 2016 Oct;23(5):391–4.
Schauer SG, April MD, Naylor JF, Maddry JK, Arana AA, Dubick MA, et al. Prehospital Application of Hemostatic Agents in Iraq and Afghanistan. Prehospital Emerg care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2018;22(5):614–23.
Lyon M, Johnson D, Gordon R. Use of a Novel Abdominal Aortic and Junctional Tourniquet to Reduce or Eliminate Flow in the Brachial and Popliteal Arteries in Human Subjects. Prehospital Emerg care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2015;19(3):405–8.
King DR, Larentzakis A, Ramly EP. Tourniquet use at the Boston Marathon bombing: Lost in translation. J Trauma Acute Care Surg. 2015 Mar;78(3):594–9.
Shina A, Lipsky AM, Nadler R, Levi M, Benov A, Ran Y, et al. Prehospital use of hemostatic dressings by the Israel Defense Forces Medical Corps: A case series of 122 patients. J Trauma Acute Care Surg. 2015 Oct;79(4 Suppl 2):S204-9.
Scerbo MH, Holcomb JB, Taub E, Gates K, Love JD, Wade CE, et al. The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. J Trauma Acute Care Surg. 2017 Dec;83(6):1165–72.
Inaba K, Siboni S, Resnick S, Zhu J, Wong MD, Haltmeier T, et al. Tourniquet use for civilian extremity trauma. J Trauma Acute Care Surg. 2015 Aug;79(2):232–3.
Scerbo MH, Mumm JP, Gates K, Love JD, Wade CE, Holcomb JB, et al. Safety and Appropriateness of Tourniquets in 105 Civilians. Prehospital Emerg care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2016;20(6):712–22.
Mckee JL, Mckee IA, Ball CG, Tan E, Moloff A, McBeth P, et al. The iTClamp in the treatment of prehospital craniomaxillofacial injury: a case series study. J Inj Violence Res. 2019 Jan;11(1):29–34.
Leonard J, Zietlow J, Morris D, Berns K, Eyer S, Martinson K, et al. A multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma. J Trauma Acute Care Surg. 2016 Sep;81(3):441–4.
Teixeira PGR, Brown CVR, Emigh B, Long M, Foreman M, Eastridge B, et al. Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. J Am Coll Surg. 2018 May;226(5):769-776.e1.
Ross EM, Mapp JG, Redman TT, Brown DJ, Kharod CU, Wampler DA. The Tourniquet Gap: A Pilot Study of the Intuitive Placement of Three Tourniquet Types by Laypersons. J Emerg Med. 2018 Mar;54(3):307–14.
Callaway DW, Robertson J, Sztajnkrycer MD. Law enforcement-applied tourniquets: a case series of life-saving interventions. Prehospital Emerg care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2015;19(2):320–7.
Paquette R, Bierle R, Wampler D, Allen P, Cooley C, Ramos R, et al. External Soft-Tissue Hemostatic Clamp Compared to a Compression Tourniquet as Primary Hemorrhage Control Device in Pilot Flow Model Study. Prehosp Disaster Med. 2019 Apr;34(2):175–81.
Haider AH, Piper LC, Zogg CK, Schneider EB, Orman JA, Butler FK, et al. Military-to-civilian translation of battlefield innovations in operative trauma care. Surgery. 2015 Dec;158(6):1686–95.
Te Grotenhuis R, Van Grunsven PM, Heutz WMJM, Tan ECTH. Use of Hemostatic Nasal Plugs in Emergency Medical Services in the Netherlands: A Prospective Study of 33 Cases. Prehospital Emerg Care. 2018;22(1):91–8.
NCT03035695. Studying Safety & Efficacy of Axiostat® Dressing in Acute Hemorrhage Due to Trauma-Comparative Study. Https:// [Internet]. 2017; Available from:
Te Grotenhuis R, Van Grunsven PM, Heutz WMJM, Tan ECTH. Prehospital use of hemostatic dressings in emergency medical services in the Netherlands: A prospective study of 66 cases. Injury. 2016 May;47(5):1007–11.
Ode G, Studnek J, Seymour R, Bosse MJ, Hsu JR. Emergency tourniquets for civilians: Can military lessons in extremity hemorrhage be translated? J Trauma Acute Care Surg. 2015 Oct;79(4):586–91.
Tan ECTH, Peters JH, Mckee JL, Edwards MJR. The iTClamp in the management of prehospital haemorrhage. Injury. 2016 May;47(5):1012–5.

Agenzie di supporto

Come citare

Sorrentino, D., Guasconi, M., Calò, F., & Lucenti, E. (2020). Gestione non farmacologica delle emorragie nel setting pre-ospedaliero. Scenario® - Il Nursing Nella Sopravvivenza, 37(3), 28–34.