| 1. |
- Goolsby, Craig, et al.
(författare)
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The Untrained Publics Ability to Apply the Layperson Audiovisual Assist Tourniquet vs a Combat Application Tourniquet: A Randomized Controlled Trial
- 2023
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Ingår i: Journal of the American College of Surgeons. - : LIPPINCOTT WILLIAMS & WILKINS. - 1072-7515 .- 1879-1190. ; 236:1, s. 178-186
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although the Stop the Bleed campaigns impact is encouraging, gaps remain. These gaps include rapid skill decay, a lack of easy-to-use tourniquets for the untrained public, and training barriers that prevent scalability. A team of academic and industry partners developed the Layperson Audiovisual Assist Tourniquet (LAVA TQ)& mdash;the first audiovisual-enabled tourniquet for public use. LAVA TQ addresses known tourniquet application challenges and is novel in its design and technology. STUDY DESIGN: This study is a prospective, randomized, superiority trial comparing the ability of the untrained public to apply LAVA TQ to a simulated leg vs their ability to apply a Combat Application Tourniquet (CAT). The study team enrolled participants in Boston, MA; Frederick, MD; and Linkoping, Sweden in 2022. The primary outcome was the proportion of successful applications of each tourniquet. Secondary outcomes included: mean time to application, placement position, reasons for failed application, and comfort with the devices. RESULTS: Participants applied the novel LAVA TQ successfully 93% (n = 66 of 71) of the time compared with 22% (n = 16 of 73) success applying CAT (relative risk 4.24 [95% CI 2.74 to 6.57]; p < 0.001). Participants applied LAVA TQ faster (74.1 seconds) than CAT (126 seconds ; p < 0.001) and experienced a greater gain in comfort using LAVA TQ than CAT. CONCLUSIONS: The untrained public is 4 times more likely to apply LAVA TQ correctly than CAT. The public also applies LAVA TQ faster than CAT and has more favorable opinions about its usability. LAVA TQs highly intuitive design and built-in audiovisual guidance solve known problems of layperson education and skill retention and could improve public bleeding control. (c) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
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| 2. |
- Goralnick, Eric, et al.
(författare)
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Defining a Research Agenda for Layperson Prehospital Hemorrhage Control A Consensus Statement
- 2020
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Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 3:7
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Tidskriftsartikel (refereegranskat)abstract
- 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 priori–defined 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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| 3. |
- Prytz, Erik, 1985-, et al.
(författare)
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Evaluating the Effect of Bleeding Control Kit Locations for a Mass Casualty Incident Using Discrete Event Simulation
- 2020
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Ingår i: Proceedings of the 17th ISCRAM Conference. - : Information Systems for Crisis Response and Management. - 9781949373271 ; , s. 167-178
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Konferensbidrag (refereegranskat)abstract
- The purpose of this study was to develop a simulation model to evaluate bleeding control kit location strategies for a mass casualty incident scenario. Specifically, the event simulated was an explosion at a large sports arena. The model included a representation of the arena itself, simulated crowd movements following the detonation of an improvised explosive device, injuries and treatments, and different ways for immediate responders to help injured patients using tourniquets. The simulation model gave logically consistent results in the validation scenarios and the simulation outcomes were in line with the expected outcomes. The results of the different tourniquet location scenarios indicated that decentralized placement (more than one location) is better, easy access is important (between rather than at emergency exits) and that an increased number of available tourniquets will result in an increased number of survivors.
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| 4. |
- Prytz, Erik, 1985-, et al.
(författare)
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First and Immediate Responders : Current capability needs and research challenges
- 2019
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Ingår i: Proceedings of the Human Factors and Ergonomics Society Annual Meeting. ; , s. 640-641
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Konferensbidrag (refereegranskat)abstract
- The purpose of this panel will be to discuss current research and challenges relating to the work of first and immediate responders. The main discussion of the panel will have panelist challenge human factors researchers to consider new directions of research addressing current capability and knowledge gaps faced by the first and immediate responder communities.
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| 5. |
- Steins, Krisjanis, et al.
(författare)
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Recommendations for Placement of Bleeding Control Kits in Public Spaces-A Simulation Study
- 2023
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Ingår i: Disaster Medicine and Public Health Preparedness. - : CAMBRIDGE UNIV PRESS. - 1935-7893 .- 1938-744X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Objective:Bleeding control measures performed by members of the public can prevent trauma deaths. Equipping public spaces with bleeding control kits facilitates these actions. We modeled a mass casualty incident to investigate the effects of public bleeding control kit location strategies.Methods:We developed a computer simulation of a bomb exploding in a shopping mall. We used evidence and expert opinion to populate the model with parameters such as the number of casualties, the publics willingness to aid, and injury characteristics. Four alternative placement strategies of public bleeding control kits in the shopping mall were tested: co-located with automated external defibrillators (AEDs) separated by 90-second walking intervals, dispersed throughout the mall at 10 locations, located adjacent to 1 exit, located adjacent to 2 exits.Results:Placing bleeding control kits at 2 locations co-located with AEDs resulted in the most victims surviving (18.2), followed by 10 kits dispersed evenly throughout the mall (18.0). One or 2 kit locations placed at the malls main exits resulted in the fewest surviving victims (15.9 and 16.1, respectively).Conclusions:Co-locating bleeding control kits with AEDs at 90-second walking intervals results in the best casualty outcomes in a modeled mass casualty incident in a shopping mall.
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| 6. |
- Strauss-Riggs, Kandra, et al.
(författare)
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Recommended Process Outcome Measures for Stop the Bleed Education Programs
- 2021
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Ingår i: AEM Education and Training. - : John Wiley and Sons Inc.. - 2472-5390. ; 5:1, s. 139-142
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Tidskriftsartikel (refereegranskat)abstract
- Trauma is a critical public health issue as the lead-ing cause of death for Americans between theages of 1 and 44 years.1In response to this reality, anumber of Stop the Bleed educa tion programs arebeing implemented to teach the lay public how to stopexsanguinating hemorrhage in preventable deaths.2Todate, there are limited data available to compare effec-tiveness of these programs. Because there is limitedcapacity to track outcome measures at this time,authors offer direction to practitioners on 12 processmeasures that will best allow comparisons among pro-grams to make informed decisions when implement-ing Stop the Bleed education
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