A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application

Lowndes, Bethany R.; Forsyth, Katherine L.; Prytz, Erik; Johnson, Carl Oscar; Abdelrahman, Amro M.; Sztajnkrycer, Matthew D.; Franz, Walter B.; Blocker, Renaldo C.; Hallbeck, M. Susan

doi:10.1177/1541931213601873

Cited by 2 publications

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“…The Combat Application Tourniquet (CAT) was used during the experiment. Tourniquet application performance was measured using a slightly revised assessment checklist as used in previous studies (Lowndes et al, 2017). Each application was given a score between 1 and 8 based on tourniquet placement, strap and windlass tightness, notation of time, and how secure the tourniquet was for transportation without mounted at each task station, recording the task including one experienced Tactical Combat Casualty Care instructor, analyzed the video material for task performance according to the assessment template, as well as recorded time to complete application and time to bleeding control, in seconds.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations

et al. 2021

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Objective The purpose of this study was to compare laypeople’s and professional first responders’ ability to perform tourniquet application and cardiopulmonary resuscitation (CPR) during calm and stressful circumstances. Background Life-threatening bleeding is a major cause of death that could be prevented by fast and appropriate first aid interventions. Therefore, laypeople are now being trained in bleeding control skills, transforming them from bystanders to immediate responders. However, critics have questioned whether laypeople are able to perform during more stressful conditions. Method Twenty-four laypersons and 31 professional first responders were tested in two conditions: a calm classroom scenario and a stressful scenario consisting of paintball fire and physical exertion. Stress and workload were assessed along with task performance. Results The experimental manipulation was successful in terms of eliciting stress reactions. Tourniquet application performance did not decline in the stressful condition, but some aspects of CPR performance did for both groups. First responders experienced higher task engagement and lower distress, worry and workload than the laypeople in both the calm and stressful conditions. Conclusion Stress did not affect first responders and laypeople differently in terms of performance effects. Stress should therefore not be considered a major obstacle for teaching bleeding control skills to laypeople. Application Tourniquet application can be taught to laypeople in a short amount of time, and they can perform this skill during stress in controlled settings. Concerns about laypeople’s ability to perform under stress should not exclude bleeding control skills from first aid courses for civilian laypeople.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations

et al. 2021

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Mechanical Assessment of Tissue Properties During Tourniquet Application

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Introduction Successful tourniquet application increases survival rate of exsanguinating extremity hemorrhage victims. Tactile feedback during tourniquet application training should reflect human tissue properties in order to increase success in the field. This study aims to understand the mechanical properties of a human limb during tourniquet application. Method Six cadaveric extremities—three uppers and three lowers—were tested from three body mass index groups: low (<19) healthy (19-24), and overweight (>24). Each specimen donned with a tourniquet and mounted to a servo-hydraulic testing machine, which enabled controlled tightening of the tourniquet while recording the tourniquet tension force and strap displacement. A thin-film pressure sensor placed between the specimen and the tourniquet recorded contact pressure. Each limb was tested with the tourniquet applied at two different sites resulting in testing at the upper arm, forearm, thigh, and shank. Results The load displacement curves during radial compression were found to be nonlinear overall, with identifiable linear regions. Average contact pressure under the tourniquet strap at 200N and 300N of tension force was 126.3 (σ = 41.2) mm Hg and 205.3 (σ = 75.3) mm Hg, respectively. There were no significant differences in tissue stiffness or contact pressure at 300N of tension force between limb (upper vs. lower) or body mass index. At 200N of tension, the upper limb had significantly higher contact pressure than the lower limb (P = 0.040). Relative radial compression was significantly different between upper (16.74, σ = 4.16%) and lower (10.15, σ = 2.25%) extremities at 200N tension (P = 0.005). Conclusions Simulation of tissue compression during tourniquet application may be achieved with a material exhibiting elastic properties to mimic the force-displacement behavior seen in cadaveric tissue or with different layers of material. Different trainers for underweight, healthy, and overweight limbs may not be needed. Separate tourniquet training fixtures should be created for the upper and lower extremities.

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A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application

Cited by 2 publications

References 13 publications

The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations

The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations

Mechanical Assessment of Tissue Properties During Tourniquet Application

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