Feasibility of RIC
death
Of the 25 enrolled patients in the Sham arm, the intervention was completed in 23 patients: 2 of the patients did not have the intervention initiate due to death of one patient after enrolment and another patient was not able to initiate the intervention within the inclusion period time frame. Of the 25 enrolled patients in the RIC arm, 20 patients completed the RIC intervention. The intervention was not initiated in 3 patients due to the inability to draw admission blood from one patient, one patient opted out of the study, and one patient was not able to initiate RIC within the inclusion period time frame. Two of RIC patients had the intervention started but prematurely terminated before all the cycles were completed due to the necessity to perform vascular surgery on the leg which RIC was performed and one patient had the intervention stopped during the first ischemic cycle due to discomfort. In addition, 4 patients from the Sham arm and 5 patients from the RIC arm had the RIC cycles interrupted due to transfer of the patients out to other departments including the Intensive Care Unit, CT Scan, or Operating Room where the interventions were resumed following transfer. The mean time for the completion of the intervention for patients who had the intervention interrupted was not significantly different between the Sham intervention (68 ± 22 min) and the RIC intervention (68 ± 21 min, P = 0.99).The mean duration from injury to application of the Sham intervention (114 ± 53 min) was not different in comparison to the RIC intervention (130 ± 50 min, P = 0.31). The mean duration from the time of injury to completion of the intervention was also not significantly different between Sham (154 ± 56 min) and RIC (181 ± 46 min, P = 0.09) patients. Both arms had two patients in which completion of the intervention exceeded the 4 h inclusion period time frame. Significant positive correlations were observed between APACHE II score (Supplementary Fig. The median duration for transport time from the arrival to scene of injury to admission was 25 min (IQR: 15, 34) by ambulance and 70 min (IQR: 51, 85) by helicopter. Those patients who had prolonged transport time were due to transfers from other hospitals. These data suggest there is potentially sufficient time for pre-hospital application of RIC during EMS transport.