Haemorrhage control in the prehospital setting: a scoping review protocol

Ezeibe, Chibuike; McCarty, Justin C; Chaudhary, Muhammad Ali; Jager, Elzerie de; Herrera-Escobar, Juan P.; Andriotti, Tomas; Jarman, Molly P.; Ortega, Gezzer; Goralnick, Eric

doi:10.1136/bmjopen-2019-029051

Cited by 5 publications

(8 citation statements)

References 9 publications

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“…This training could be not only focused on clinicians but also extended to paramedics, nurses and even laypersons. In the literature, there are publications in which laypersons are starting to be trained with a very positive outcome [ 9 , 10 , 11 , 12 ]. This is done using simulators which are not automated, and which do not allow objective evaluation of the techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, some of the actions used in this military environment can be adopted in the civilian environment, especially after the events that promoted the Hartford consensus which highlights that everyone could save a life [ 9 ]. In this way, actions like the campaign “Stop the Bleed” [ 10 , 11 , 12 , 13 ] take momentum, approaching training to laypersons so they could learn how to identify different types of hemorrhages and how to control them.…”

Section: Introductionmentioning

confidence: 99%

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Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Larraga-García

Pérez-Jiménez

Ros-Dopico

et al. 2021

Sensors

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One of the main preventable leading causes of death after a trauma injury is the hemorrhagic shock. Therefore, it is extremely important to learn how to control hemorrhages. In this paper, a hemorrhagic trauma simulator for lower limb has been developed and a pilot study has been accomplished to trail the simulator. Four different bleeding scenarios have been tested per participant, gathering information about the manual pressure exerted to control the bleeding. Data, altogether, from 54 hemorrhagic scenarios managed by final year medical students and doctors were gathered. Additionally, a post-simulation questionnaire, related to the usability of the simulator, was completed. All the participants managed to control the simulated bleeding scenarios, but the pressure exerted to control the four different scenarios is different depending if the trainee is a student or a doctor, especially in deep venous hemorrhages. This research has highlighted the different approach to bleeding control treatment between medical students and doctors. Moreover, this pilot study demonstrated the need to deliver a more effective trauma treatment teaching for hemorrhagic lesions and that hemorrhagic trauma simulators can be used to train and evaluate different scenarios.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Larraga-García

Pérez-Jiménez

Ros-Dopico

et al. 2021

Sensors

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“…Before the conference, a scoping review on layperson prehospital hemorrhage control encompassing both peer-reviewed and non-peer-reviewed literature was conducted. 10 The results of the review were categorized into 5 themes based on available literature and investigator discussion: (1) epidemiology and effectiveness, (2) materials, (3) education, (4) global health, and (5) health policy. The scoping review was distributed to participants before the conference, and each participant was assigned 2 of the 5 themes for rating.…”

Section: Methodsmentioning

confidence: 99%

Defining a Research Agenda for Layperson Prehospital Hemorrhage Control

Goralnick¹,

Ezeibe²,

Chaudhary³

et al. 2020

JAMA Netw Open

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IMPORTANCE Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector. OBJECTIVE To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons. EVIDENCE REVIEW The 2-day, in-person, National Stop the Bleed (STB) Research Consensus Conference was conducted on February 27 to 28, 2019, to identify and achieve consensus on research gaps. Participants included (1) subject matter experts, (2) professional society-designated leaders, (3) representatives from the federal government, and (4) representatives from private foundations. Before the conference, participants were provided a scoping review on layperson prehospital hemorrhage control. A 3-round modified Delphi consensus process was conducted to determine high-priority research questions. The top items, with median rating of 8 or more on a Likert scale of 1 to 9 points, were identified and became part of the national STB research agenda. FINDINGS Forty-five participants attended the conference. In round 1, participants submitted 487 research questions. After deduplication and sorting, 162 questions remained across 5 a prioridefined themes. Two subsequent rounds of rating generated consensus on 113 high-priority, 27 uncertain-priority, and 22 low-priority questions. The final prioritized research agenda included the top 24 questions, including 8 for epidemiology and effectiveness, 4 for materials, 9 for education, 2 for global health, and 1 for health policy. CONCLUSIONS AND RELEVANCE The National STB Research Consensus Conference identified and prioritized a national research agenda to support laypersons in reducing preventable deaths due to life-threatening hemorrhage. Investigators and funding agencies can use this agenda to guide their future work and funding priorities.

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“…In the United States, trauma is the leading cause of death in individuals between the ages of 1 and 45. At the same time, uncontrolled hemorrhage has been identified as being the leading cause of preventable injury death [1][2][3]. As a result, there has been an emphasis on hemorrhage control training for lay people and first responders through programs such as the American College of Surgeons (ACS), the Stop the Bleed (STB) program, and Emergency Medical Technician (EMT) certification courses.…”

Section: Introductionmentioning

confidence: 99%

The Impact of the Addition of a Virtual Reality Trainer on Skill Retention of Tourniquet Application for Hemorrhage Control Among Emergency Medical Technician Students: A Pilot Study

Arif¹,

Felipes²,

Hoxhaj³

et al. 2023

Cureus

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Introduction: Trauma is a leading cause of preventable death in the United States. Emergency Medical Technicians (EMTs) often arrive first at the scene of traumatic injuries to perform life-saving skills such as tourniquet placement. While current EMT courses teach and test tourniquet application, studies have shown efficacy and retention of EMT skills such as tourniquet placement decay over time, with educational interventions needed to improve retention of skills.Methods: A prospective randomized pilot study was conducted to determine differences in retention of tourniquet placement among 40 EMT students after initial training. Participants were randomly assigned to either a virtual reality (VR) intervention or a control group. The VR group received instruction from a refresher VR program 35 days after initial training as a supplement to their EMT course. Both the VR and control participants' tourniquet skills were assessed 70 days after initial training by blinded instructors.Results: There was no significant difference in correct tourniquet placement between both groups (Control, 63% vs Intervention, 57%, p = 0.57). It was found that 9/21 participants (43%) in the VR intervention group failed to correctly apply the tourniquet while 7/19 of the control participants (37%) failed in tourniquet application. Additionally, the VR group was more likely to fail the tourniquet application due to improper tightening than the control group during the final assessment (p = 0.04). Conclusion:In this pilot study, using a VR headset in conjunction with in-person training did not improve the efficacy and retention of tourniquet placement skills. Participants who received the VR intervention were more likely to have errors relating to haptics, rather than procedure-related errors.

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Haemorrhage control in the prehospital setting: a scoping review protocol

Cited by 5 publications

References 9 publications

Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Defining a Research Agenda for Layperson Prehospital Hemorrhage Control

The Impact of the Addition of a Virtual Reality Trainer on Skill Retention of Tourniquet Application for Hemorrhage Control Among Emergency Medical Technician Students: A Pilot Study

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