SIMPLE METHODS OF HEMOSTASIS IN FIELD CONDITIONS: TOURNIQUETS, HEMOSTATIC DRESSINGS, IMPROVISED MEANS

This study systematically analyzes 50 scientific sources published between 2006 and 2025, focusing on the effectiveness and safety of various hemostatic methods employed in field conditions. Three primary categories of bleeding control strategies were identified: mechanical devices (specifically arterial tourniquets), bioactive hemostatic agents (such as chitosan- or kaolin-based dressings), and improvised means used in resource-limited settings. Arterial tourniquets, including CAT, SOF-T, and AAJT models, demonstrated the highest effectiveness in managing massive extremity hemorrhage, with an average survival rate of 92% and a mean hemostasis time of 35 seconds. Complication rates remain relatively low (approximately 8%) when application protocols are followed. These devices are indispensable in emergency medical services, military environments, and prehospital trauma care, especially for extremity injuries with critical arterial bleeding. Hemostatic dressings based on kaolin and chitosan show high efficacy (85–88% survival) in controlling bleeding in anatomically complex zones where tourniquets are ineffective, such as the torso, groin, and neck. Their mechanism of action integrates chemical coagulation activation, platelet aggregation, and mechanical vascular sealing. Additional antimicrobial and tissue regenerative properties enhance their utility in tactical and civilian emergency medicine. Improvised hemorrhage control methods, although less effective (50–70% survival) and associated with higher complication rates (20–30%), play a critical role in austere environments lacking specialized medical equipment. Their application requires a basic understanding of vascular anatomy, compression techniques, and time monitoring to mitigate the risk of ischemia, necrosis, and other adverse outcomes. The findings underscore the necessity of standardized training programs in primary hemostasis for medical personnel, military forces, and civilians. Practical recommendations emphasize equipping emergency systems with modern hemostatic tools, incorporating tactical medicine curricula at all levels of healthcare education, and promoting public access to basic bleeding control knowledge and tools. Technological innovations—such as smart tourniquets, biodegradable agents, and AI-assisted hemostasis algorithms—are proposed as future directions. This study provides a comprehensive evidence base to guide the selection and deployment of bleeding control strategies in diverse emergency scenarios, contributing significantly to the advancement of tactical and disaster medicine.