Do tourniquets for extremity injuries save lives?

Hemorrhage is the leading cause of preventable death in trauma, and tourniquets have become standard for extremity hemorrhage in both civilian settings and combat. Proponents argue that timely and properly applied tourniquets significantly improve survival in appropriately selected patients. Critics of frequent tourniquet use highlight the high rates of inappropriate application and associated complications, especially with prolonged use. Both sides agree that tourniquets can be lifesaving, but emphasize the need for proper training, appropriate use, and implementation of tourniquet conversion and replacement strategies. Evolving experience underscores the importance of adapting tourniquet use to modern battlefield and civilian realities. This manuscript summarizes a debate held at the 42nd Annual Point/Counterpoint Acute Care Surgery Conference regarding the benefits and risks of tourniquet use for extremity injuries.