Trauma is one of the leading causes of uncontrolled haemorrhage, death, and disability. Use of a tourniquet can be considered an optimal anti-haemorrhagic resource, in pre-hospital and emergency settings, and its lifesaving effect is clinically contradictory. This review aims to assess the clinical efficacy of the tourniquet in the emergency pre-hospital care setting for the management of haemorrhage. We conducted the systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the PRISMA statement. We searched the following electronic databases: EMBASE, MEDLINE, and Cochrane-CENTRAL. All studies included were appraised for risk of bias. Prevalent primary outcomes were mortality and use of blood products. Secondary outcomes were related to adverse effects. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). Four studies were involved (1762 trauma patients). The adjusted odds ratio (aOR) of 0.47 (95% confidence Interval (CI) 0.19–1.16; three studies; 377 patients) for overall mortality estimates did not give a clear indication of the benefits of emergency pre-hospital tourniquets (PH-TQ) versus no pre-hospital tourniquet (NO PH-TQ) placement. The adjusted mean difference for blood product use was −3.28 (95% CI −11.22, 4.66) for packed red blood cells (pRBC) and −4.80 (95% CI −5.61, −3.99) for plasma, respectively. The certainty of evidence was downgraded to very low for all outcomes. Our results suggest an unclear effect of emergency pre-hospital tourniquet placement on overall mortality and blood product use. However, this systematic review highlights the availability of only observational studies and the absence of high quality RCTs assessing the efficacy of PH-TQs. Randomized controlled trials are needed.

Registries require standardized component libraries based on predefined taxonomies to ensure detailed and structured descriptions of implanted devices, enabling effective monitoring of implant safety. Considering the growing use of spinal implantable devices, we aimed to propose a comprehensive classification framework for spinal devices, to be integrated into the Italian Spine registry framework. The taxonomy was created using a detailed process that included reviewing existing literature, analyzing technical documents, selecting important device characteristics, obtaining feedback from manufacturers, and converting the information into a format suitable for IT systems. Our findings showed the lack of a globally accepted classification system. We identified four primary categories, further refined into subcategories, complemented by attributes for device identification, traceability, and characterization, then structured them using XSD schemas. Our proposal represents the first known attempt to implement a taxonomy for spinal implants, with the potential to serve as an international reference. A structured classification system would enhance registry interoperability, facilitate cross-registry comparability, and improve the early detection of adverse events, thereby strengthening patient safety and clinical outcomes. Furthermore, the adoption of a unified classification framework would improve surgeons’ clinical practice and support policymakers in developing early prevention strategies, ultimately improving patient care.