The iTClamp in the management of prehospital haemorrhage

IntroductionBleeding remains a leading cause of death in trauma patients. The iTClamp is a temporary wound closure device designed to control external bleeding within seconds of injury. We describe our experience using this device on 10 patients in the prehospital environment.MethodsWe have implemented the iTClamp for prehospital use through our physician-staffed helicopter emergency medical service (HEMS). Indications were massive bleeding that could not be controlled with an ordinary compressive bandage or a haemostatic bandage.ResultsTen patients were treated with the iTClamp. Seven patients had a severe head injury due to various traumas, one patient had a neck injury from a disk cutter, one patient had an open chest wound and one patient had an open femur fracture. After applying the iTClamp, bleeding was controlled in 90% of these patients (n = 9), with complete cessation reported in 60% (n = 6), partial cessation with adequate control reported in 30% (n = 3); in one patient, the bleeding could not be controlled with the iTClamp alone. It took an average of 10 s to apply the iTClamp, and the average usage satisfaction score was 7.7.ConclusionWe conclude that the iTClamp is a safe, fast and useful tool for stopping or controlling external blood loss in our series of prehospital patients. Further studies of the iTClamp are needed to determine which patients might benefit from this device.