b'Scientific Session Abstracts SUNDAY APRIL 21, 202443: ANALYSIS OF TOURNIQUET APPLICATION IN THE SETTING OF PENETRATING VASCULAR INJURY Emelyn Magtanong, MD, Hans Boggs, MD, Kaushik Mukherjee, MD, Sharon Kiang, MD Loma Linda University Medical Center, Loma Linda, CAIntroduction: Tourniquets have become increasingly utilized in civilian trauma over the last decade, though with limited data describing their clinical implementation or outcomes. EAST guidelines currently recommend the use of tourniquets in penetrating extremity injuries prior to hospital arrival for management of hemorrhage in which manual compression or compression dressings are unsuccessful or inadequate.Objective: Our goal was to assess rates of tourniquet use in penetrating extremity vascular injuries as well as differences in demographics, management, and outcomes in patients with and without tourniquets at our institution.Methods: A retrospective review of a prospectively maintained database was performed at a single level 1 trauma center. All adult patients presenting with penetrating extremity vascular injuries between January 2014 and December 2019 were identified. Prehospital tourniquet use and tourniquet application within the ED were analyzed. Patient demographics, Injury Severity Scores, Mangled Extremity Severity Scores, mechanisms of injury, presenting vitals and laboratory markers, time from injury to OR, surgical management, as well as limb-related outcomes were also noted and compared.Results: A total of 49 penetrating extremity vascular injuries were identified. There were 25 (51%) upper extremity (axillobrachial) and 24 (48%) lower extremity (femoropopliteal) injuries. Sixteen patients (33%) received tourniquets11 (22%) had prehospital placement and 5 (10%) received tourniquet application upon arrival to the ED. Gunshot wounds were the presenting mechanism in 90% of patients (n=43). There was no difference in utilization between the upper (n=8; 16%) and lower (n=8; 16%) extremity groups. Patients with tourniquet received surgical care significantly faster than those without (64.7 vs 150.5 min, p=0.007). Patients without tourniquet placement tended to have higher Injury Severity Scores (12.1 vs 15.3; p=0.410) 110SOUTHERN CALIFORNIA VASCULAR SURGICAL SOCIETY'