Despite extensive clinical experience with circumferential pneumatic counterpressure (CPC) in the control of hemorrhage and the treatment of shock, many physicians who care for patients with such life-threatening problems have failed to add this technique to their therapeutic storehouse. This lack of universal acceptance has not, however, prevented widespread use of CPC—particularly in the prehospital setting—where there have been wide variations in the pressures used, duration of application, and recognized indications.
In an effort to bring some order out of this chaos, Pelligra and Sandberg (p 708) have reviewed the 75 years of reported clinical experience with CPC. They have assessed its efficacy, reviewed the physiological effects, suggested indications and contraindications for its use, described the various devices that are available for applying such pressure, and even recommended an optimal technique.
For specialists in emergency medicine and critical care, these authors have provided data to help convince skeptical colleagues of