Serious game training improves performance in combat life-saving interventions

Planchon, Jérôme; Vacher, Anthony; Comblet, Jeremy; Rabatel, E.; Darses, Françoise; Mignon, Alexandre; Pasquier, Pierre

doi:10.1016/j.injury.2017.10.025

Cited by 15 publications

(7 citation statements)

References 17 publications

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“…The French Military Medical Service doctrine is based on the early and continuous application of a damage control strategy (including resuscitation and surgery) that begins at the point of injury, continues throughout successive medical evacuations (MEDEVAC), and culminates in transfer to a military training hospital in France 28–31 . As part of this damage control strategy aimed at controlling bleeding and limiting immediate preventable deaths, all French servicemen are trained in “ Sauvetage au combat” , the French equivalent of Tactical Combat Casualty Care 32–34 . To achieve aggressive bleeding control and prevention of coagulopathy, Remote Damage Control Resuscitation includes early administration of tranexamic acid, transfusion of French lyophilized plasma (FLYP), and restricted use of crystalloids; this is performed from the point of injury and during forward and tactical MEDEVACs to Role 2 facilities 7,35 .…”

Section: Methodsmentioning

confidence: 99%

“…[28][29][30][31] As part of this damage control strategy aimed at controlling bleeding and limiting immediate preventable deaths, all French servicemen are trained in "Sauvetage au combat", the French equivalent of Tactical Combat Casualty Care. [32][33][34] To achieve aggressive bleeding control and prevention of coagulopathy, Remote Damage Control Resuscitation includes early administration of tranexamic acid, transfusion of French lyophilized plasma (FLYP), and restricted use of crystalloids; this is performed from the point of injury and during forward and tactical MEDEVACs to Role 2 facilities. 7,35 Role 2 facilities are forward resuscitation and surgical units that perform triage, damage control surgery, and post-operative resuscitation care over several hours before strategic air MEDEVAC to a Role 4 facility in France.…”

Section: Contextmentioning

confidence: 99%

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An observational study of the blood use in combat casualties of the French Armed Forces, 2013–2021

Pons

Boyé

et al. 2022

Transfusion

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Background The French Armed Forces conduct asymmetric warfare in the Sahara‐Sahel Strip. Casualties are treated with damage control resuscitation to the extent possible. Questions remain about the feasibility and sustainability of using blood for wider use in austere environments. Methods We performed a retrospective analysis of all French military trauma patients transfused after injury in overseas military operations in Sahel‐Saharan Strip, from the point of injury, until day 7, between January 11, 2013 to December 31, 2021. Results Forty‐five patients were transfused. Twenty‐three (51%) of them required four red blood cells units (RBC) or more in the first 24H defining a severe hemorrhage. The median blood product consumption within the first 48 h, was 8 (IQR [3; 18]) units of blood products (BP) for all study population but up to 17 units (IQR [10; 27.5]) for the trauma patients with severe hemorrhage. Transfusion started at prehospital stage for 20 patients (45%) and included several blood products: French lyophilized plasma, RBCs, and whole blood. Patients with severe hemorrhage required a median of 2 [IQR 0; 34] further units of BP from day 3 to day 7 after injury. Eight patients died in theater, 4 with severe hemorrhage and these 4 used an average of 12 products at Role 1 and 2. Conclusion The transfusion needs were predominant in the first 48 h after the injury but also continued throughout the first week for the most severe trauma patients. Importantly, our study involved a low‐intensity conflict, with a small number of injured combatants.

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Section: Methodsmentioning

confidence: 99%

Section: Contextmentioning

confidence: 99%

An observational study of the blood use in combat casualties of the French Armed Forces, 2013–2021

Pons

Boyé

et al. 2022

Transfusion

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“…Similar to aviation simulators which train pilots in emergency procedures, serious games have been used to train surgeons in situational awareness for addressing crises and their ability to anticipate nonroutine adverse events during surgery [108A]. Serious games have been used to train forward combat casualty care medical personnel in a hostile remote environment advanced lifesaving procedures and trauma triage to non-trauma specialists [109][110][111].…”

Section: Game-based Learning Health Security Applicationsmentioning

confidence: 99%

Simulation and Modeling Applications in Global Health Security

French

2020

Advanced Sciences and Technologies for Security Applications

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Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats [1]. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats [2].Ebola Virus Disease (EVD), Middle East Respiratory Syndrome (MERS) and other emerging infectious diseases (EID) are also concerns for GHS. The world faces increasing challenges related to natural and manmade disasters as the frequency and magnitude of disasters have increased significantly over the past 30 years. Healthcare workers protect the well-being of people around the world by preventing, detecting, and responding to public health threats. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging threats [3].There is a global public health workforce shortage. The WHO tracks healthcare workforce data on 186 countries, and 57 were insufficient in healthcare provider availability and accessibility [4]. The 2013-2016 African EVD epidemic revealed WHO organizational deficiencies in coordinating responses to public health emergencies and a shifting of priorities away from global health security threats [5]. It Providing initial and sustainment training to the diverse GHS healthcare workforce is expensive and inefficient utilizing the traditional classroom model. Greater demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate healthcare providers in the ever-expanding body of disaster medicine knowledge [22].Many of these challenges can be met with gaming and simulation technologies new generations of GHS responders have embraced. Simulation-based training (SBT) has been demonstrated to provide effective learning and is increasingly being integrated into healthcare provider education [23]. The advantages of SBT may be summarized as follows: (1) safety-simulated lives and health can be jeopardized to any extent required for training without harming any people; (2) economy-simulated material and equipment can be used, misused, and expended;(3) visibility-simulation can provide visibility in two ways; you can make the invisible visible and control the visibility of details allowing the learner to discern the forest from the trees or the trees from the forest as needed; (4) time control -simulator time can be sped up, slowed down, or stopped. It can also be completely reversed, allowing learners to replicate specific problems, events, or opera...

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“…Therefore, the stress-level might be lower compared to real combat situations. Innovative and dedicated tools, such as serious games, 31 , 32 could improve this training and be particularly effective in case of unexpected deployment with shortened operational preparation.…”

Section: Limitationsmentioning

confidence: 99%

Tourniquet Training Program Assessed by a New Performance Score

Martinez

Duron²,

Schaal

et al. 2018

Prehosp. Disaster med.

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IntroductionApplication of a tourniquet is the cornerstone in management of combat-related extremity hemorrhages. Continuous and appropriate training is required to use tourniquets correctly.HypothesisThe aim of this study was to analyze the impact of a refresher training session, conducted directly in the theater of military operations, on the performance of tourniquet use.MethodsDuring their deployment (October 2015-April 2016) in the Central African Republic, a first simulation session evaluated soldiers from two combats platoons for the application of the SOFFT (Special Operation Forces Tactical Tourniquet; Tactical Medical Solutions; Anderson, South California USA) tourniquet. After randomization, a R (+) group underwent a refresher training session, while a R (−) group did not. Two months later, a second simulation session was conducted for both groups: R (+) and R (−). A dedicated score (one to seven points), including delay and effectiveness, evaluated the soldiers’ performance for tourniquet application.ResultsTwenty-six subjects were included in the R (+) group and 24 in the R (−) group. Between the two assessments, the score improved for 61.5% of subjects of the R (+) group and 37.5% subjects of the R (−) group (P=.09). More particularly, the performance score increased from 4.2 (SD=1.4) to 5.5 (SD=0.9; P=.002) in subjects of the R (+) group whose last training for tourniquet application was over six months prior.ConclusionA refresher tourniquet training session, conducted directly in a combat zone, is especially effective for soldiers whose last training session was over six months prior. A dedicated score can assess appropriately the performance of tourniquet training.MartinezT, DuronS, SchaalJV, BaudoinY, BarbierO, DabanJL, BoutonnetM, AussetS, PasquierP. Tourniquet training program assessed by a new performance score. Prehosp Disaster Med. 2018;33(5):519–525.

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Serious game training improves performance in combat life-saving interventions

Cited by 15 publications

References 17 publications

An observational study of the blood use in combat casualties of the French Armed Forces, 2013–2021

An observational study of the blood use in combat casualties of the French Armed Forces, 2013–2021

Simulation and Modeling Applications in Global Health Security

Tourniquet Training Program Assessed by a New Performance Score

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