Training Physicians for Combat Casualty Care on the Modern Battlefield

Sohn, Vance Y.; Runser, Lloyd A; Puntel, Robert; Sebesta, James A.; Beekley, Alec C.; Theis, Jennifer; Merrill, Nancy; Roth, Bernard; Rush, Robert M.

doi:10.1016/j.jsurg.2007.05.007

Cited by 27 publications

(21 citation statements)

References 14 publications

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“…Expediting evacuation and proper triage of the wounded at the front-line hospital, ideally headed by an expert medical team and advanced medical equipment may be effective in decreasing the incidence of death in war-wounded victims [13][14][15]. This was also our experience during planned attacks on Iraq when expert medical teams were sent to front-line hospitals at the time of attack.…”

Section: Discussionmentioning

confidence: 96%

Assessment and outcome of 496 penetrating gastrointestinal warfare injuries

et al. 2010

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Penetrating abdominal injuries were common in Iranian victims of war often causing multiple organ injuries. The colon and small intestine were the more commonly injured organs and carried the most postoperative complications. Mortality at 1st line hospitals was more than double that of 2nd line hospitals; the complication rate was also greater as was the number of missed injuries. Adherence to the standard surgical protocols, prompt evaluation, proper triage and management are factors which may lower patient morbidity and complications.

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Section: Discussionmentioning

confidence: 96%

Assessment and outcome of 496 penetrating gastrointestinal warfare injuries

et al. 2010

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“…Of the 12 studies included in our review (Table 1), 10 publications [8][9][10][11][13][14][15][16][17]19 were prospective observational cohort studies and 2 12,18 were RCTs. Eight studies 8,11,13,[15][16][17][18][19] were performed in the military setting and 4 studies 9,10,12,14 in the civilian setting. Anesthetized swine were used in 8 studies [9][10][11][12][13][14]16,18 and goats 15 in 1 study; the remaining 3 studies 8,17,19 did not report the type of live tissue used for training.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight studies 8,11,13,[15][16][17][18][19] were performed in the military setting and 4 studies 9,10,12,14 in the civilian setting. Anesthetized swine were used in 8 studies [9][10][11][12][13][14]16,18 and goats 15 in 1 study; the remaining 3 studies 8,17,19 did not report the type of live tissue used for training.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Training consisted of LTT with no direct comparison to other simulations in 10 studies. [8][9][10][11][13][14][15][16][17]19 In those studies, only pre-and posttraining evaluations were performed, and LTT was conducted concurrently with other simulation methods. The remaining 2 studies 12,18 compared LTT to other training modalities.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Current use of live tissue training in trauma: a descriptive systematic review

et al. 2015

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Background: Growing public concern for animal welfare, advances in computerized simulation and economic barriers have drawn a critical eye to the use of live tissue training (LTT) in trauma skills acquisition. As a consequence, other simulation methods have replaced LTT, for example, in the Advanced Trauma Life Support (ATLS) course. Owing to the lack of clear conclusions in the literature, we conducted a systematic review to determine the value of LTT alone and in comparison to other simulation methods in trauma. Methods: We performed a systematic review of the literature considering observational studies and randomized controlled trials (RCTs) that examined LTT in trauma exclusively or compared with other simulation methods. Independently and in duplicate, we adjudicated studies for inclusion and data abstraction. We assessed the quality and risk of bias. Results: Twelve studies met our inclusion criteria: 2 RCTs and 10 prospective cohort studies. Eight and 4 studies were performed in the military and in the civilian settings, respectively. Anesthetized swine were used in 8 studies and goats in 1. The cohort studies involved LTT alone. Different adjunctive training modalities were included: mannequins in 6 studies, cadavers in 2, computer simulation in 1, video presentations in 2 and wound moulage scenarios in 1. The overall methodological quality was moderate as per the Newcastle-Ottawa score (mean 6.0 ± 0, possible range 1-9). The 2 RCTs did not demonstrate adequate random sequence generation and allocation concealment. Conclusion: There is limited evidence that other types of simulation are better than LTT. Data on training effects of LTT versus other simulations on outcomes are lacking. Contexte : Les préoccupations croissantes du public envers le bien-être des animaux, le perfectionnement des dispositifs de simulation informatisés et les contraintes budgétaires ont remis en question la formation sur tissus vivant (FTV) pour l'acquisition des compétences en traumatologie. Par conséquent, d'autres méthodes de simulation ont remplacé la FTV, par exemple, le cours ATLS (Advanced Trauma Life Support-Cours avancé de réanimation des polytraumatisés). Étant donné l'absence de conclusions claires dans la littérature, nous avons procédé à une revue systématique afin de comparer la valeur de la FTV seule à celle d'autres méthodes de simulation en traumatologie. Méthodes : Nous avons procédé à une revue systématique de la littérature, plus particulièrement des études d'observation et des essais randomisés et contrôlés (ERC) portant exclusivement sur la FTV en traumatologie ou en comparaison avec d'autres méthodes de simulation. De manière indépendante et dupliquée, nous avons sélectionné les études à inclure et nous en avons extrait les données. Nous avons évalué la qualité et le risque de biais. Résultats : Douze études répondaient aux critères d'inclusion : 2 ERC et 10 études de cohorte prospectives. Huit et 4 études ont été effectuées dans des contextes militaires et civils, respectivement. Des porcs anesthésiés on...

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“…Various institutions and organizations provide specific training courses for medical and non-medical staff to cope with disaster situations. The Emergency Medical Services (EMS) system is responsible for dealing with mass casualty incidents below the disaster level [6][7][8][9].…”

Section: Ems Systemmentioning

confidence: 99%