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Sökning: WFRF:(Prytz Erik 1985 )

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1.
  • Alkusaibati, Wael, 1990- (författare)
  • Digitalized Co-production of Emergency Response : Using Volunteers as First Responders
  • 2024
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Contemporary global challenges like global warming, rapid urban development, and the current unstable security situation, lead to an increase in large-scale crises (e.g., forest fires) alongside frequent smaller emergencies (e.g., house fires and traffic accidents). The increase in emergencies strains professional response organizations, necessitating additional resources. Civilian volunteers are therefore increasingly being integrated into the response system. The development is mediated by information and communication technologies (ICTs) which enable communication between professional responders (e.g., the municipal rescue services, the emergency medical services, the Public Swedish Answering Point) and citizens. While many studies focus on spontaneous volunteer activities emerging on social media, fewer examine organized volunteerism initiatives at the local emergency response level. Over a decade ago, a municipal rescue service in northern Sweden established an initiative recruiting volunteers as first responders and equipping them with basic response tools. The volunteers undergo training in tasks such as cardiopulmonary resuscitation (CPR) and fire extinguishing. They are dispatched to predefined response tasks using simple ICT applications like SMS lists or mobile apps. This initiative has expanded to other areas due to perceived benefits such as shorter response times and reduced casualties and material damage. The phenomenon can be labelled as an emerging form of ICT-enabled or digitalized co-production of public services. However, previous research indicates a research gap in understanding, describing, and defining this type of co-production. The overall aim of the thesis is to describe how these ICT-enabled initiatives emerge and develop over time and identify the related effects on the response system. This is expected to provide recommendations on how they can be developed and supported. This aim is divided into three specific objectives, where each has been addressed through a research paper: 1- identifying how the existing literature describes ICT-enabled/digitalized volunteerism in large- and small-scale emergencies, 2- identifying how these initiatives emerge and operate, and can be maintained in small-scale emergencies, introducing more systematized knowledge on this concept, 3- initially evaluating the contributions of volunteers in the initiatives. Leaning on a case study approach inspired by action research, a combination of data collection methods has been adopted, e.g., a literature review, interviews, and incident reports filled out by volunteers. For the data analysis, the theoretical lens of ICT-enabled/digitalized co-production of public services has been applied. The first paper is a literature review study that examines digitally enabled volunteering activities in crises and small-scale emergencies. It highlights the prevalence of studies on volunteers using social media for crowdsourcing in crises, often termed digitalized volunteerism which entails virtual and, or physical contributions by volunteers to the response efforts. In contrast, fewer studies focus on volunteers' role in local small-scale emergencies, labelled as "hybrid" ICT-enabled or digitalized coproduction. The term hybrid here refers to the loose affiliation of the volunteers where they collaborate with the rescue services but are not officially associated through binding contracts. Hence, they are in between spontaneous and organized volunteerism. Both volunteering modes support professional response systems and display similar needs for steering, financial support, coordination, and integration of ICT artifacts. However, crises require increased coordination to manage uncertainties, risks, and data overload effectively. The second paper presents three models describing the emergence of hybrid digitalized co-production initiatives in urban and rural areas, as defined in Paper 1, along with how national authorities can support them. These models i.e., Rural, Urban, and National consist of three phases: Recruitment, Response, and Maintenance. Each model exhibits distinct characteristics. In rural areas for example, there is a need for more regular training due to low alerting frequency, and the possibility of using simple dispatch ICTs as cost-effective solutions. Conversely, urban areas have more alerts, necessitating more advanced ICTs, with less emphasis on regular training compared to rural areas. At the macro-level, the national model highlights roles that national actors can play such as facilitating a joint Application Programming Interface (API), joint insurance solutions, and an ICT system that can register incoming and active volunteers. The third paper is an initial evaluation of these initiatives at emergency sites, focusing on ICT-enabled dispatch, estimated response times, tasks performed, and collaboration with professionals, to assess the effects of using volunteers. This approach contrasts with previous studies that took an overall perspective and only used qualitative data. A total of 53 incident reports were collected from volunteers, revealing that volunteers arrived before professionals in twothirds of incidents, contributing to an average gain of 5 minutes. Additionally, volunteers performed a broader range of tasks than previously described, and often continued collaboration with professionals on-site, despite the initial expectation of handing over tasks upon the arrival of professional response actors. Also, comparing this data with the rural model from Paper 2, similarities and differences emerged. For instance, there was a higher number of alerts, and the basic ICTs used for dispatch were deemed insufficient, contrary to the model's perception. The thesis’ scientific contribution is a clearer conception of digitalized co-production of, above all, local emergency response as an emerging phenomenon. In the three papers, the ICT dispatch was identified as central and needs further development to enhance this co-production form. The thesis also sheds light on the need to integrate the initiatives into the official governmental frameworks. Furthermore, the thesis provides a primary understanding of how the concept works on the ground and provides an initial evaluation of the effects. In the practical field, the thesis offers insights into the importance of volunteers as additional resources to the official response systems, highlights challenges, hindrances, and enablers, and suggests potential solutions and improvements. Future work will include a further collection of incident reports for more reliable assessments and complementary interviews with volunteers. Also, the potential role of volunteers in larger crises, for example, as part of civil preparedness, will be further explored.
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  • Andersson Granberg, Tobias, 1973-, et al. (författare)
  • Sensor Requirements for Logistics Analysis of Emergency Incident Sites
  • 2020
  • Ingår i: Proceedings of the 17th ISCRAM Conference. - : Information Systems for Crisis Response and Management. - 9781949373271 ; , s. 952-960
  • Konferensbidrag (refereegranskat)abstract
    • Using sensors to collect data at emergency incident sites can facilitate analysis of the logistic operations. This can be used to improve planning and preparedness for new operations. Furthermore, real-time information from the sensors can serve as operational decision support. In this work in progress, we investigate the requirements on the sensors, and on the sensor data, to facilitate such an analysis. Through observations of exercises, the potential of using sensors for data collection is explored, and the requirements are considered. The results show that the potential benefits are significant, especially for tracking patients, and understanding the interaction between the response actors. However, the sensors need to be quite advanced in order to capture the necessary data.
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  • Berggren, Peter, 1971-, et al. (författare)
  • Battlefield trauma care
  • 2018
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society 62nd Annual Meeting. - : Sage Publications. ; , s. 634-638
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Rapid and structured medical care is important to increase wounded patients’ chances of survival in modern warfare. This requires a functioning medical chain. Aim: The aim of this study was to expand the knowledge of how the battlefield trauma care affects patient outcome in situations with a large number of casualties in the Swedish armed forces. Methods: An empirical study with a convergent parallel mixed methods design, which included observations and semi-structured interviews. Results: The results show that the trauma care performed at Role 1-units functioned well. The most prominent issue discovered was deficiency in transportation resources for medical evacuation throughout the entire medical chain. Conclusion: Despite that the trauma care performed at Role 1-units functions well, casualties are at risk for preventable complications or death. Improved transportation logistics are required to improve the medical capabilities of the Swedish armed forces.
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  • Berggren, Peter, 1971-, et al. (författare)
  • The importance of using the designated duty officers when assessing the medical response organization
  • 2017
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundAn important aspect of disaster medicine is to be proactive and respond quickly when disaster strikes. In Sweden, the role responsible for swift medical response on the regional level is the designated duty officer.MethodsA large exercise to assess national medical response ability was conducted. Seven medical regional staffs (a total of 93 individuals participated as tested participants) were involved in handling a large train accident scenario. The exercise was run for 5 hours, where the different regional staffs were located at their regular command posts. The exercise was organized using Emergo Train Systems.ResultsSeveral capabilities were identified during the exercise as important for the organization to maintain the ability to handle a similar event: documentation and operational picture, communication and terminology, command of resources, strategy for distribution of resources, national co-ordination, and exercise development.The designated duty officers were central to the exercise in several aspects: 1) in developing and verifying a realistic scenario and preparing background information, 2) as participants in the exercise, 3) assessors of the staffs’ behaviors, and 4) as domain experts when interpreting the exercise outcome.ConclusionsUsing subject matter experts is central to many research domains. However, the more complex a situation is the larger the demand of expertise is. The technical platform allows for coordinating complex exercises, whereas the subject matter expert in terms of the designated duty officer is required to guarantee validity and reliability in these large-scale exercises.Key messages:Running complex scenarios to train and test abilities requires subject matter experts in both planning, preparation, implementation, and assessment.Sophisticated simulator and training platforms, such as Emergo Train Systems, facilitates while the designated duty officers are necessary to guarantee validity and reliability in the exercise.
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  • Brodin, Wilhelm, et al. (författare)
  • The Effect of Presence of Blood on Medical Laypeople’s Ability to Perform First Aid for Massive Bleeding
  • 2022
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society Annual Meeting. ; , s. 251-255
  • Konferensbidrag (refereegranskat)abstract
    • There are currently several educational initiatives to teach first aid courses for medical laypeople, such as the Stop the Bleed campaign. Although much research on educational initiatives has been conducted, there are still factors that remain unexplored, such as the potential effects of blood itself on laypeople’s first aid performance and educational experience. This study investigates such potential effects for performance of the first aid techniques tourniquet application and wound packing, in relation to individual differences in disgust sensitivity and medical fear of blood. The results show that the presence of blood will increase the time a medical layperson takes to apply a tourniquet and pack a wound but does not affect the quality of the aid. Additionally, the disgust sensitivity of the medical layperson was found to predict an increase in application time for the wound packing task, but not the tourniquet application task, when blood was present.
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  • Forsyth, Katherine, et al. (författare)
  • Improving Instructions to Stop the Bleed
  • 2017
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meting. - Santa Monica : Human Factors and Ergonomics Society, HFES. - 2169-5067 .- 1071-1813. ; , s. 588-592
  • Konferensbidrag (refereegranskat)abstract
    • The Stop The Bleed initiative was developed by the Department of Homeland Security to educate lay providers in bleeding reduction strategies. The current study evaluated: (1)three tourniquet instructions using a simulated tourniquet task and (2)participant confidence levels in tourniquet use and lay provider training. Thirty participants with limited clinical experience applied a tourniquet to a simulated limb using one of three instruction sets. Twelve of these participants (40%) participated in a tourniquet training session and focus group to discuss each instruction set. Participants preferred the most simple and pictoral instruction set, and identified opportunities for improvement in each set. Participant confidence in tourniquet use increased significantly following the task and the focus group. After the focus group, participant confidence in instructing lay providers on proper tourniquet use significantly increased. Adding key steps, contextual pictures, and indicators of success to instructions could support lay providers stop the bleed in life-threatening situations
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  • Friberg, Marc, et al. (författare)
  • The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations
  • 2023
  • Ingår i: Human Factors. - : SAGE PUBLICATIONS INC. - 0018-7208 .- 1547-8181. ; 65:3, s. 496-507
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective The purpose of this study was to compare laypeoples 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 laypeoples ability to perform under stress should not exclude bleeding control skills from first aid courses for civilian laypeople.
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  • Friberg, Marc, et al. (författare)
  • Training Effectiveness Factors Associated with Laypeople Hemorrhage Control Training : A Systematic Literature Review
  • 2023
  • Ingår i: Framtidens Skadeplats 2023. - Linköping : Linköping University Electronic Press.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • IntroductionHemorrhage control initiated by laypeople, or immediate responders, can be a crucial link for increased survival among victims with hemorrhage. An increased interest in hemorrhage control training for laypeople have resulted in numerous publications in the area, showing that training laypeople in hemorrhage control can be successful (Nichols & Horstman, 2022; Tang et al., 2022). To this date, it is unknown which training factors are associated with successful training outcomes and to what extent. The objective of this study is to review and analyze past and present literature on hemorrhage control training for laypeople, in order to highlight current knowledge gaps, and direct future research.MethodA systematic literature review was performed by reviewing and analyzing the literature. Five electronic databases, CINAHL, Embase, PubMed, Scopus, and Web of Science, were used in the literature search. Search keywords were chosen among the variations and synonyms to the words: “laypeople” AND “hemorrhage” AND “training” AND “stop the bleed”. To examine where the knowledge gaps exist in terms of training effectiveness, a theoretical model by Cannon-Bowers et al. (1995) was chosen as theoretical lens, and each record was categorized into six training outcome categories: reactions, attitude change, learning, training performance, job performance, and results/organizational effectiveness, according to the content of the reviewed studies.Preliminary resultsIn total, 2962 records were initially identified for screening, and 1186 records were kept after duplicate removal and deletion of incomplete records. After title and abstract review, 186 records were sought for retrieval. This will be further reduced into a fewer number of records for full text review after additional screening. By categorizing the records into the six training outcome categories, previous research efforts can be highlighted, as well as it creates an opportunity for future research suggestions.ConclusionBy equipping the public with the necessary knowledge and tools for hemorrhage control, lives can be saved. By examining the literature on hemorrhage control training effectiveness, suggestions for future research and educational practice can be made.
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  • Goralnick, Eric, et al. (författare)
  • Defining a Research Agenda for Layperson Prehospital Hemorrhage Control A Consensus Statement
  • 2020
  • Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 3:7
  • 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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  • Hermelin, Jonas, et al. (författare)
  • Operationalising resilience for disaster medicine practitioners : capability development through training, simulation and reflection
  • 2020
  • Ingår i: Cognition, Technology & Work. - : Springer. - 1435-5558 .- 1435-5566. ; 22:3, s. 667-683
  • Tidskriftsartikel (refereegranskat)abstract
    • Resilience has in recent decades been introduced as a term describing a new perspective within the domains of disaster management and safety management. Several theoretical interpretations and definitions of the essence of resilience have been proposed, but less work has described how to operationalise resilience and implement the concept within organisations. This case study describes the implementation of a set of general resilience management guidelines for critical infrastructure within a Swedish Regional Medical Command and Control Team. The case study demonstrates how domain-independent guidelines can be contextualised and introduced at an operational level, through a comprehensive capability development programme. It also demonstrates how a set of conceptual and reflective tools consisting of educational, training and exercise sessions of increasing complexity and realism can be used to move from high-level guidelines to practice. The experience from the case study demonstrates the value of combining (1) developmental learning of practitioners’ cognitive skills through resilience-oriented reflection and interaction with dynamic complex open-ended problems; (2) contextualisation of generic guidelines as a basis for operational methodological support in the operational environment; and (3) the use of simulation-based training as part of a capability development programme with increasing complexity and realism across mixed educational, training and exercise sessions. As an actual example of a resilience implementation effort in a disaster medicine management organisation, the study contributes to the body of knowledge regarding how to implement the concept of resilience in operational practice.
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  • Hälso- och sjukvårdens förmåga att hantera en allvarlig händelse med många skadade : erfarenheter och lärdomar av Övning TYKO
  • 2016
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Den 3 mars 2016 fick Socialstyrelsen i uppdrag av regeringen att öva hälsooch sjukvårdens förmåga att hantera en allvarlig händelse med många skadade. Myndigheten beslutade att genomföra övningen som en funktionell simuleringsövning med motspel. De övade utvärderades med hjälp av mätbara kvalitetsindikatorer som tidigare identifierats inom ramen för Socialstyrelsens arbete med att ta fram en gemensam modell för särskild sjukvårdsledning vid allvarlig händelse. Inför övningen skapades ett scenario som var utmanande för hälso- och sjukvården men, för att möjliggöra genomförandet inte innefattade alla potentiella komplexa faktorer. En kritisk observation är att analysen utifrån en övning bör vara restriktiv med slutsatser ifall dessa inte samtidigt kan styrkas utifrån tidigare övningar eller verkliga händelser. Övningens scenario samt patienternas skadepanorama och utfall visualiserades med hjälp av simuleringsverktyget Emergo Train System® och dess instruktörer vid Katastrofmedicinskt Centrum i Linköping. Ett väsentligt mål med övningen var att den ska utgöra ett underlag för att stärka förmågan inom hälso- och sjukvården genom att identifiera utvecklingsområden. I rapporten redovisas under övningen identifierade förmågor och utvecklingsområden som myndigheten bedömer som viktiga för att upprätthålla, säkra och förbättra förmågan att hantera allvarliga händelser: • Dokumentation och lägesbild • Kommunikation och terminologi • Mobilisering och dirigering av resurser • Fördelningsstrategi och gränssättande kapacitet • Nationell samordning • Övningsteknisk utveckling En gemensam lägesbild är viktig efter som det stödjer de involverade aktörerna i arbetet med att värdera behovet av stöd under pågående händelse. Därför var en viktig del i övningens utvärdering huruvida påverkade landsting hade förmågan att snabbt skapa sig en uppfattning om aktuellt behov, tillgängliga resurser och hur ytterligare pre- hospitala samt hospitala resurser skulle kunna mobiliseras. Dessa kritiska faktorer skapar förutsättningar för att korrekta fördelningsstrategier för de skadande patienterna ska kunna utarbetas. Övning Tyko visade att staber med hög upplevd arbetsbelastning och låg upplevd situationsmedvetenhet hade svårt att värdera sitt eget behov av stöd från andra aktörer. Att i förväg ha kännedom om vilken typ av stöd man behöver och kan förvänta sig i olika situationer kräver ett arbete för att identifiera detta redan i före-perspektivet. Det går inte att utesluta att en annan överblick av tillgängliga resurser och en annan förutsägbarhet i vad som kan förväntas av andra hade föranlett en annan fördelningsstrategi som hade förbättrat patientfallet i övningen. För att avgöra effektiviteten av fattade beslut i enlighet med framtagna strategier behövs även en förmåga till 8 HÄLSO- OCH SJUKVÅRDENS FÖRMÅGA ATT HANTERA EN ALLVARLIG HÄNDELSE MED MÅNGA SKADADE SOCIALSTYRELSEN uppföljning huruvida tagna beslut får förväntad effekt inom rimlig tid, under övningen observerades kommunikationsproblem gällande kvittens, förfrågan och bekräftelse. En viktig sammanfattande slutsats som Socialstyrelsen drar inför fortsatt arbete är att myndigheten ska verka för att etablera en funktion för nationell samordning med syfte att ge förutsättningar till en bättre behovs- och resursmatchning vid stora skadeutfall. Inom ramen för en sådan samordning bör gemensamma triage och larmkriterier, medicinska bedömningskriterier och skadeklassificeringar, gemensamma rapportmallar och system för distribution av diagnostiskt material samt gemensam terminologi m.m. inkluderas. Metoder och teknik för framtagandet och kommunikationen av fördelningsnycklar och aktuella kapacitetsbedömningar över tid behöver tas fram för att skapa förutsättningar för en aktuell bild av resurstillgången. Socialstyrelsen vill skapa förutsättningar för ett nationellt kompetenscentrum med inriktning på ökad förmåga och samordning i hela traumavårskedjan. I detta arbete kan även arbetet med Socialstyrelsens förmåga till nationell samordning under pågående händelse utarbetas, definieras och implementeras. Myndigheten vill slutligen lyfta fram att en samlad nationell plan för både trauma- och katastrofmedicinsk utbildning och övning ger ytterligare förutsättningar att upprätthålla och öka förmågan att hantera allvarliga händelser. Dessa viktiga slutsatser avser myndigheten ta med sig in i sitt fortsatta arbete med att stärka hälso-och sjukvårdens förmåga vid allvarlig händelse.
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  • Iversen, Katarina, et al. (författare)
  • Uppföljning av Stop the Bleed-utbildning för räddningstjänsten
  • 2021
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I ett samarbete mellan Linköpings universitet och MSB (Myndigheten för samhällsskydd och beredskap) har ett utbildningskoncept baserat på STB (Stop the Bleed) för svensk räddningstjänst tagits fram (Prytz & Jonson, 2019). I samband med utvecklingen av utbildningen genomfördes pilotutbildningar under 2018 och 2019 med Sörmlandskustens Räddningstjänst, Räddningstjänsten i Eskilstuna och Västra Sörmlands Räddningstjänst. Forskning har visat att kunskaperna från utbildning i blödningskontrollerande åtgärder börjar förfalla så snart som 30 dagar efter genomförd utbildning (Pasley et al., 2018), liksom för andra kunskaper som hjärt-lungräddning (HLR; Madden, 2006; Moser & Coleman, 1992; Broomfield, 1996, Zieber & Sedgewick, 2018). Det finns därför ett behov av fler uppföljningsstudier efter utbildningar i blödningskontroll för att förstå hur kunskaper bibehålls över tid (Goralnick et al., 2020). Vidare finns även ett behov att följa upp den praktiska nyttan av utbildningar i blödningskontrollerande första hjälpen-åtgärder och effekten på räddningstjänstens förmåga. Den aktuella studien är en uppföljningsstudie av pilotutbildningen som genomfördes 2018/2019. Forskningsfrågorna som ämnades besvaras i studien var:Hur har kunskaperna om blödningskontroll förändrats under den tid som gått sedan utbildningen 2018/2019? Har den räddningstjänstpersonal som utbildades i blödningskontroll haft praktisk nytta av utbildningen? Hur förberedda upplevde de sig vara i de situationerna? Har erfarenheter av skarpa situationer påverkat tilltron personalen har till sin egen förmåga att hantera svåra blödningar? Studien genomfördes som en kvantitativ enkätstudie. Totalt deltog 48 representanter från räddningstjänsterna i Sörmland i studien. Resultatet visar inledningsvis att kunskapsnivån hos räddningstjänstpersonalen är fortsatt hög med goda resultat på kunskapsprovet. Nivån är dock något lägre 2021 än vad den var 2018/2019. Vidare visade resultaten att en majoritet av den räddningstjänstpersonal som svarade på enkäten har hanterat skarpa situationer med blödningar efter att de genomfört pilotutbildningen och att den upplevda nyttan med utbildningen var hög. Deltagarnas självförtroenden gällande hanteringen av skarpa situationer var högre efter utbildningen, jämfört med skarpa situationer de upplevt innan utbildningen. Över lag visar resultatet att denna typ av utbildning ökar räddningstjänstens förmåga att hantera händelser där det förekommer allvarliga blödningar, och att räddningstjänstpersonalen är positivt inställda till utbildningar i den form som gavs i pilotutbildningen 2018/2019.
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  • Jonson, Carl-Oscar, Docent, 1978-, et al. (författare)
  • Efficacy of Video-Based Instructions for Laypeople Bleeding Control Education
  • 2019
  • Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:s1, s. 90-90
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction:The Stop the Bleed campaign in the United States aims to teach bleeding control techniques, such as tourniquets, to the public. Educational consortium guidelines advocate using brief web- or video-based material. Another option is posters or flyers distributed at, for example, workplaces or public spaces.Aim:The aim of the current study was to evaluate the relative efficacy between a flyer and a video to teach tourniquet application skills to members of the public in Sweden.Methods:A total of 38 participants (27 male, 11 female) from the general public completed the study. Their ages ranged from 19 to 73 (M=32, SD=14). None had prior experience with tourniquet applications. One group (n=18) received tourniquet instructions on a flyer and one (n=20) received a 5-minute video instruction. Both groups completed pre- and post-questionnaires and a practical tourniquet application test.Results:Independent samples t-tests showed that the video-based instructions resulted in fewer application errors (M=1.40 out of 10, SD=1.19) compared to the flyer group (M=3.61, SD=2.40), t(36)=3.651, p=0.001, and higher post-task satisfaction (M=3.89 out of 5, SD=0.74 compared to M=3.39, SD=1.15). However, the flyer-group was faster (M=86.22 seconds, SD=27.28) compared to the video group (M=112.25, SD=42.22), t(36)=2.229, p=0.032.Discussion:Video instructions appear superior to flyers in terms of teaching correct tourniquet application to the general public. The longer total application time includes steps taken after bleeding control has been achieved (e.g. securing tourniquet straps and time notation), which may have contributed to the application time difference. The results support the educational guidelines that suggest video-based instructions for teaching basic tourniquet skills to laypeople are more effective.
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23.
  • Kircher, Katja, 1973-, et al. (författare)
  • Train driver attention is influenced by the type of railway signalling system
  • 2022
  • Ingår i: DDI 2022 Gothenburg. - Göteborg : Safer. ; , s. 50-52
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The European Rail Traffic Management System (ERTMS) will replace national standards with the aim to promote cross-border traffic and enhance efficiency. The transition involves a shift from lineside signalling to mostly in- cabin information via a Driver Machine Interface (DMI). Previous research indicates that this may lead to a decrease in driver attention to the outside world and to a decrease in workload, leading to boredom. Using a train simulator, 41 participants drove the same track with the ERTMS system and the Swedish national standard (ATC) while wearing eye- tracking equipment. Subjective workload and boredom assessments were made after each drive. An analysis of the first set of reduced data (15 participants) showed that the formal attentional requirements like the monitoring of speed changes and signals were fulfilled in almost all cases, regardless of system. Overall, however, the data indicate that in line with previous research the drivers focus their attention more to the inside of the train when using the ERTMS system. This is corroborated by the finding that horn blowing is slightly delayed with the ERTMS system. Perceived workload was generally low, with the ERTMS system experienced to be more boring. We draw the preliminary conclusion that while formal attentional requirements are fulfilled for both systems, the ERTMS system likely has a tendency to pull the drivers’ overall attention inwards. Given that for the ERTMS system most relevant information is presented inside of the train on the DMI, this is not surprising, but needs to be addressed by the authorities.
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24.
  • Lantz Cronqvist, Mattias, et al. (författare)
  • Development and Initial Validation of a Stochastic Discrete Event Simulation to Assess Disaster Preparedness
  • 2019
  • Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:1, s. 118-118
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction:Assessing disaster preparedness in a given region is a complex problem. Current methods are often resource-intensive and may lack generalizability beyond a specific scenario. Computer-based stochastic simulations may be an additional method but would require systems that are valid, flexible, and easy to use. Emergo Train System (ETS) is an analog simulation system used for disaster preparedness assessments.Aim:To digitalize the ETS model and develop stochastic simulation software for improved disaster preparedness assessments.Methods:A simulation software was developed in C#. The simulation model was based on ETS. Preliminary verification and validation (V&V) tests were performed, including unit and integration testing, trace validation, and a comparison to a prior analog ETS disaster preparedness assessment exercise.Results:The software contains medically validated patients from ETS and is capable of automatically running disaster scenarios with stochastic variations in the injury panorama, available resources, geographical location, and other variables. It consists of two main programs: an editor where scenarios can be constructed and a simulation system to evaluate the outcome. Initial V&V testing showed that the software is reliable and internally consistent. The comparison to the analog exercise showed a general high agreement in terms of patient outcome. The analog exercise featured a train derailment with 397 injured, of which 45 patients suffered preventable death. In comparison, the computer simulation ran 100 iterations of the same scenario and indicated that a median of 41 patients (IQR 31 to 44) would suffer a preventable death.Discussion:Stochastic simulation methods can be a powerful complement to traditional capability assessments methods. The developed simulation software can be used for both assessing emergency preparedness with some validity and as a complement to analog capability assessment exercises, both as input and to validate results. Future work includes comparing the simulation to real disaster outcomes.
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25.
  • Lidestam, Björn, 1968-, et al. (författare)
  • Akutvård under ambulansfärd : naturalistiska data från simulerade typsituationer vid körning på testbana
  • 2019
  • Ingår i: Sammanställning av referat från Transportforum 2019. - : VTI.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Målen för detta projekt var att undersöka det aktuella kunskapsläget samt att samla in naturalistiska fordonsdynamiska data samt beteendedata vid olika simulerade utryckningsscenarier för att framöver utforma realistiska och prototypiska körscenarier med tillhörande vårduppgifter för användning i ambulanssimulatorförsök och träning av ambulanspersonal. Methods: För att uppnå målen genomfördes tre delstudier: en litteraturstudie, en workshop och ett fältexperiment på testbana. Results: Resultat Av litteraturstudien framgick det att den tidigare forskningen främst studerat kvaliteten av HLR under transporter. Trots skillnader i definitioner av kvalitet, tillämpade standarder och studiedesign framstår det som att det tveklöst föreligger svårigheter att under transport utföra hjärt–lungräddning (HLR) med hög kvalitet. Några studier har undersökt orsakerna till varför det är svårt att utföra HLR med god kvalitet och det har identifierats faktorer relaterade till transportförfarandet, fordonstyp och vårdutrymmets design. Under workshopen identifierades ett flertal vårdinterventioner som svåra att genomföra under transport; och de ansågs generellt som svårare att genomföra under transport i ambulansen än annars (t.ex. på sjukhus). Det framkom också en del faktorer som ansågs påverka vårdinterventionerna under transport. Dessa påverkansfaktorer kunde delas in i kategorierna rörelserelaterade, designrelaterade, vägbanans statusoch samarbete. Flertalet av dessa faktorer överensstämmer med de faktorer som rapporterats i litteraturstudien. Under fältexperimentet på testbana rapporterade deltagarna ökad arbetsbelastning och ökad svårighet i att utföra vårdinterventionerna allt eftersom transporten bestod av fler och hårdare hastighetsförändringar och kurvtagningar. Med ökad svårighetsgrad ökade även förekomsten av färdrelaterade faktorer, vilket var den kategori som ansågs påverka utförandet av interventionerna i störst utsträckning. Slutsatser Många vårdinterventioner, inte bara HLR, är svåra att utföra under transport. Orsakerna till svårigheterna som uppstår under transport kan hänföras till hur ambulansen rör sig, hur vårdutrymmet är designat, hur vägbanan är beskaffad, och hur samarbetet mellan föraren och den som vårdar patienten fungerar. Rörelserelaterade orsaker ter sig proportionerliga mot svårigheterna att utföra vårdinterventioner – men alla vårdinterventioner påverkas inte på samma sätt och i samma utsträckning, vilket bör studeras vidare.
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26.
  • Lidestam, Björn, 1968-, et al. (författare)
  • Full SPEED ahead : Säker och effektiv utryckningskörning genom simulatorbaserad träning
  • 2023
  • Ingår i: Framtidens Skadeplats 2023. - Linköping : Linköping University Electronic Press. - 9789180751278 - 9789180751261
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Det pågående projektet SPEED (Swedish Project for Efficient Emergency Driving) presenteras. Syftet är att i samverkan med ambulansverksamheter och övriga blåljusslag utveckla simulatorbaserad träning, speciellt i syfte att träna upp blivande blåljusförare i att hantera risksituationer i trafiken under stresspåslag. Simulatormetodiken möjliggör (1) att detta kan göras utan de fysiska risker som finns i verklig trafik; (2) att risksituationerna kan styras så att det säkerställs att alla blivande utryckningsförare exponeras för dem; (3) att risksituationerna kan repeteras; och (4) att föraren kan få omedelbar och tydlig återkoppling för att lära av sina egna misstag. Studiens experimentgrupp ska få träna på ett urval med specifika risksituationer för utryckningskörning, medan kontrollgruppen får motsvarande träning i simulator, fast endast med likadana trafiksituationer som ingår i träning för personbilskörkort. Skillnaden mellan specifik träning för utryckningskörning och personbilskörning mäts med ett simulatorscenario där dels ett antal av liknande, men ej identiska, trafiksituationer som ingått i träningen ingår, dels ett antal kritiska trafiksituationer som inte ingått i tidigare träning. Projektet genomförs i samverkan med simulatorföretagen Skillster och Tenstar, som ska implementera resultat och lärdomar i sina produkter. 
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27.
  • Lowndes, Bethany, et al. (författare)
  • A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application
  • 2017
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meeting. - Santa Monica : Human Factors and Ergonomics Society, HFES. - 2169-5067 .- 1071-1813. ; , s. 1076-1080
  • Konferensbidrag (refereegranskat)abstract
    • The American College of Surgeons (ACS) and the Department of Homeland Security (DHS) encourage the use of tourniquets as part of the “Stop the Bleed” campaign. Both have provided instructions for layperson tourniquet application in order to save the life of a hemorrhaging trauma victim. This study sought to compare the impact of using ACS and DHS instructions with manufacturer-provided instructions for the completion of simulated tourniquet application steps. Thirty surgical trainees completed a simulated tourniquet application with one of the three instruction sets. Their completion time and success for each step were measured. Participants that received ACS instructions failed the fewest number of steps (p < 0.01) and completed the task faster (Mean (SD) = 70 (33) seconds) compared to those with the manufacturer-provided instructions (p < 0.01). Tourniquet instruction sets need to be refined in order to optimize the success rate of just-in-time guidance for tourniquet application.
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28.
  • Lowndes, Bethany, et al. (författare)
  • Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed"
  • 2019
  • Ingår i: Military medicine. - : Oxford University Press. - 0026-4075 .- 1930-613X. ; 184:3-4, s. 28-36
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveThe American College of Surgeons (ACS) encourages clinicians to provide training to laypeople on tourniquet application. It is unclear whether clinicians are confident in their abilities and equipped with adequate knowledge, skills, and resources. This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions.MethodsThirty surgical trainees performed a tourniquet application simulation using a Combat Application Tourniquet and one of the three instructions sets developed by ACS, Department of Homeland Security, and the tourniquet manufacturer. Participants reported tourniquet knowledge, attitudes, and confidence and discussed the instructions. One instruction set was updated and compared to the original set with 20 new trainees.ResultsParticipants with ACS instructions passed the greatest number of steps (p < 0.01) and completed the task significantly faster compared to those with manufacturer instructions (p < 0.01). Participants (80%) reported favorable views toward tourniquets but 30–60% did not align with to ACS tourniquet guidelines. Focus group participants suggested revisions to the ACS instructions. Comparing the original and revised version of these instructions resulted in no significant improvements.ConclusionsACS instructions provide guidance; however, improvements to tourniquet instruction are needed for success in controlling exsanguinating hemorrhage.
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29.
  • Norrblom, Petter, et al. (författare)
  • Vad motiverar frivilliga att fortsätta vara frivilliga?
  • 2023
  • Ingår i: Framtidens Skadeplats 2023. - Linköping : Linköping University Electronic Press.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Organiserade frivilliga är en allt viktigare del av samhällets beredskap. Initiativ som Sms-livräddare och Civila Insatspersoner (CIP) kan stötta professionella responsorganisationer och möjliggöra snabbare respons till händelser som hjärtstopp eller mindre bränder. Att få personer att ställa upp som frivilliga och sedan fortsätta vara frivilliga är väsentligt för att dessa initiativ ska ha en samhällsnytta. Tidigare studier har visat att det finns många faktorer som motiverar personer att bli frivilliga. Det saknas dock forskning på vilka faktorer som är mest avgörande för att personer ska fortsätta vara engagerade som frivilliga.Därför genomfördes våren 2022 en enkätstudie av forskare inom Centrum för Forskning i Respons- och Räddningssystem (CARER), där 5 300 personer som var engagerade antingen som Sms-livräddare eller CIP:ar svarade på frågor om vad som motiverade dem att vara frivilliga och om de hade för avsikt att fortsätta vara frivilliga i framtiden. En explorativ faktor-analys genomfördes för att visa på de underliggande faktorer som var gemensamma i svaren. I denna faktoranalys upptäcktes totalt 12 underliggande faktorer baserat på de 48 frågorna i enkäten. Dessa faktorer analyserades därefter med en regressionsanalys för att undersöka vilka av dessa som är mest avgörande i frivilligas motivation att fortsätta vara frivilliga.Resultatet visade att de faktorer som hade störst positiv inverkan på motivationen att fortsätta vara frivillig var Socialt sammanhang, Självbild, och Kompetens. De faktorer som hade störst negativ inverkan var Larmtrötthet och Negativa upplevelser. Resultaten från studien kan användas för att genomföra interventioner för att öka frivilligas motivation, genom att till exempel motverka larmtrötthet genom smartare utlarmningsalgoritmer eller utbildningsinsatser som ökar de frivilligas kompetens, och då förhoppningsvis även behålla fler frivilliga över tid.
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30.
  • Norrblom, Petter, et al. (författare)
  • Where and how do people search for medical emergency equipment in public buildings?
  • 2023
  • Ingår i: 67th Annual Meeting of the Human Factors and Ergonomics Society. - Washington, D.C..
  • Konferensbidrag (refereegranskat)abstract
    • Exsanguinating trauma is a common cause of death. Placing bleeding control kits in public areas has been suggested as a countermeasure. Similarly, automatic external defibrillators (AEDs) are placed in public areas in case of cardiac arrests. Both severe bleeding and cardiac arrests require rapid care and people must be able to quickly find relevant emergency equipment. This study explores where and how people search for such equipment. Twenty participants wearing eye-tracking glasses searched for bleeding control kits and AEDs in a public building. The participants visually searched features such as signs with maps, written information, and other emergency equipment. The participants expressed elevators and staircases, open areas, entrances, and the reception to be places where medical emergency equipment would likely be placed. The results suggest that these features and places may be suitable for medical emergency equipment or directions.
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31.
  • Ohlander, Ulrika, et al. (författare)
  • Performance using low-cost gaze-control for simulated flight tasks
  • 2016
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society Europe Chapter 2016 Annual Conference. ; , s. 201-210
  • Konferensbidrag (refereegranskat)abstract
    • In the current study, interaction using gaze control was compared to computer mouse using the MATB-II (Multi-Attribute Task Battery) environment. The study had two aims; the first was to explore the utility of low-cost technologies in a rapid prototyping and testing environment for aviation. The second aim was to use such an environment to compare a novel interaction device (a low-cost gaze control device) to a familiar interaction device (computer mouse). Method: Thirty participants performed two scenarios with each interaction device. The software MATB-II provided simulated flight tasks and recorded performance. Mental workload was assessed by the NASA Task Load Index (TLX) questionnaire after each scenario. Results: The results showed that gaze control resulted in significantly higher overall mental workload than computer mouse. Performance was better with mouse in two of the four tasks. Conclusions: Concerning the first aim, the study demonstrated the value of low-cost technology for initial user testing before using more expensive high-fidelity environments. Concerning the second aim, the computer mouse resulted in better performance and lower mental workload. This may either be due to higher user familiarity with computer mouse interaction or to limitations of the gaze control equipment and insufficient adjustments of the interface design to optimize for gaze control.
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32.
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33.
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34.
  • Pettersson, Jenny, 1974- (författare)
  • Resilience in medical incident command
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Natural and manmade disasters are becoming more common and are creating increasingly complex response challenges. In Sweden, the responsibility for disaster management and disaster preparedness lies with the regions. Disaster preparedness includes the provision of training and exercises in medical command and control to establish the ability to create surge capacity. Resilience can serve as a theoretical perspective to identify crucial capabilities for managing disasters and can be defined within the domain of disaster medicine, as the ability to withstand, absorb, and react to the impact of disasters while preserving and augmenting essential health services, and subsequently recovering to the system’s original state or adapting to a new one. Research on resilience in medical command and control may contribute to evidence-based teaching and training for medical incident command. The aim of this thesis is to contribute to new knowledge about resilience in medical command and control and how to implement resilience in disaster management teaching and training.  Methods: This thesis is based on four studies using a mix of qualitative and qualitative methods with both deductive and inductive approaches. In study I, a within-group pretest–posttest design was used to examine 13 head nurses´ general and specific self-efficacy before and after an intervention of three short computer-based simulation exercises. Study II was a case study focusing on a regional medical incident command taking part in a capability development program combining education, training, and exercises. In study III, an experienced medical incident command participated in a functional exercise and behaviors were captured through observations, video, and audio recordings. Using the markers and strategies analytic framework, observable behavior that exemplified resilient practice were identified. Study IV was a semi-structured, retrospective, in-depth interview study with an inductive design relying on the Critical Decision Method   Results: Study I showed an increase in head nurses´ general but not specific self-efficacy. They also exhibited improved management skills, as indicated by shorter time-to-treatment for both trauma patients and in-hospital patients in the last exercise. Study II offers an example of how a resilience concept can be introduced to, contextualized, and operationalized with medical incident command personnel through a combination of education, training, and exercises. Study III shows an empirical link from resilience concepts to observable behaviors during an exercise in medical command and control. Study IV identified factors affecting decision-making in medical command and control during the early phase of COVID-19.  Conclusions: The results contribute valuable insights to the understanding of challenges, strategies, education, and training methods related to resilience in medical command and control. 
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35.
  • Pettersson, Jenny, et al. (författare)
  • Resilience Training of Regional Medical Command and Control
  • 2019
  • Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:1, s. 164-165
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction:Resilience is often described as a desirable holistic approach to disaster preparedness. However, the term has a wide variety of meanings and is hard to operationalize and implement in disaster management. A goal for the EU H2020 project DARWIN was to operationalize resilience for incident management teams.Aim:To test the resilience operationalization by analyzing command team behaviors in a major incident exercise and trace observations to resilience theory.Methods:A regional medical command and control team (n=11) was observed when performing in a functional simulation exercise of a mass casualty incident (300 injured, 1800 uninjured) following the collision of a cruise ship and an oil tanker close to the Swedish coast. Audio and video recordings of behaviors and communications were reviewed for resilient behaviors based on the DARWIN guidelines using the “resilience markers for small teams” framework (Furniss et al., 2011).Results:A total of 121 observed instances of resilient behaviors were found in the material. In 95 cases (79%) the observed behaviors followed a priori hypothesized connections between resilient strategies and general markers. Certain marker-strategy combinations occurred frequently, such as 18 observations where the strategy “understand crucial assumptions” occurred together with the marker “adapting to expected and unexpected events.”Discussion:Resilience has the potential to contribute to a more holistic disaster management approach. The findings that the observations, in general, correspond to the expected relationship between theoretical concretization and contextualization supports the DARWIN effort to operationalize resilience theory. This is a prerequisite for developing observational protocols for training and further studies of resilient behaviors in disaster management teams.
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36.
  • Phillips, Rachel, et al. (författare)
  • Comparing Blood Loss Estimates by Medical Laypeople in Online and In-person Formats using SABLE
  • 2021
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society Annual Meeting. - : SAGE Publications. - 2169-5067 .- 1071-1813. ; , s. 1352-1356
  • Konferensbidrag (refereegranskat)abstract
    • To design interventions for teaching laypeople how to respond in hemorrhage situations, it is necessary to understand factors that influence their perception of blood loss. Although lab-based research offers more experimental control, it limits access to certain kinds of participants. Therefore, the purpose of this study was to compare results from an online administration of a web-based application (SABLE) to data collected using the same application in a lab. Participants viewed 78 5-second video clips of simulated bleeding injuries with a male or female victim and different volumes of blood loss. They estimated the volume of blood loss after each video. The results replicated the general findings from prior research and revealed no significant differences in estimations or estimation accuracy between the online and lab-based administration of SABLE. Results are discussed in terms of applicability to research practice. 
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37.
  • Phillips, Rachel, et al. (författare)
  • Visual Blood Loss Estimation Accuracy : Directions for Future Research Based on a Systematic Literature Review
  • 2020
  • Ingår i: Proceedings of the 2020 HFES 64th International Annual Meeting. - : Sage Publications. ; , s. 1411-1415
  • Konferensbidrag (refereegranskat)abstract
    • Visual blood loss estimation occurs in a variety of medical contexts and may impact everything from interventions by immediate responders to the likelihood of receiving blood transfusions in a hospital setting. However, research suggests that visual blood loss estimation is inaccurate for laypeople and medical professionals. The aim of the current study was to conduct a systematic literature review to determine the current state of knowledge on visual blood loss estimation accuracy and identify directions for future research. A structured search resulted in 1799 titles that were subsequently screened. A total of 72 articles were coded for comparison. Based on the evaluation, several gaps were identified, most notably related to factors of the situation that may influence estimation accuracy such as blood flow and victim/patient gender. Directions for future research are proposed based on identified gaps.
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38.
  • Prytz, Erik, 1985-, et al. (författare)
  • A pilot investigation of the effect of transport-related factors on care quality in a moving ambulance
  • 2019
  • Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:1, s. 158-158
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction:Providing patient care in a moving ambulance can be difficult due to various transport-related factors, (e.g., accelerations, lateral forces, and noise). Previous research has primarily focused on cardiopulmonary resuscitation (CPR) performance effects but has neglected to investigate other care interventions.Aim:To test a range of different care interventions during different driving scenarios.Methods:A workshop with ambulance practitioners was held to create a list of care interventions to be tested. Two ambulance practitioners were recruited to drive an ambulance on a closed test-track while performing care interventions on simulation models. Three driving scenarios of differing difficulty were used. Main outcome measures were estimates of workload using the NASA Task Load Index (TLX) and task difficulty. G-forces and video-data were also collected.Results:Estimated workload increased overall as the difficulty of the driving scenario increased, as did task difficulty estimates. However, some care scenarios and interventions were affected less. For example, placing intravenous access increased greatly in difficulty, whereas saturation and blood pressure measurements had more modest increases. TLX scores showed that the primarily estimated physical workload and effort that increased, but also mental and temporal demands for some care scenarios. The more difficult driving scenarios primarily increased the variability of measured G-forces but not necessarily the overall driving speed, indicating that force variability is an important factor to study further.Discussion:The study was intended as an initial pilot test of a wide range of care interventions. It will serve as input to future, larger studies of specific interventions and transport-related factors. Overall, this small pilot indicates that more interventions than only CPR should be studied in moving ambulances to investigate potential performance effects. This is important for traffic, patient, and work safety for ambulance workers and patients.
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39.
  • Prytz, Erik, 1985-, et al. (författare)
  • Evaluating learning and simulation exercise efficacy for a course on advanced prehospital trauma
  • 2017
  • Ingår i: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017. - : Cambridge University Press. ; , s. S222-S223
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Study/Objective: In this study, we aimed to design a questionnaire battery for course and simulation exercise evaluation, and pilot-test the battery by evaluating a course on Advanced Prehospital Trauma Care (APTC).Background: Many course evaluations suffer from simplistic metrics, such as whether the course participants “enjoyed” the course. In contrast, the current study sought to measure (self-estimated) pre- and post-course knowledge, relevant to specific learning objectives, as well as questions pertaining to specific factors of the simulation exercises used in the course (eg, fidelity/realism, learning objective fit, transferability of tools/procedures, usefulness, among others) were selected based on simulation theory and simulation-based training literature.Methods: Data were collected during a course on APTC. Twelve students participated. The mean professional experience was 15.5 years. The participants completed an informed consent form prior to the study. They completed a pre-course questionnaire, a post-course questionnaire, and a course evaluation form.Results: The mean self-estimated improvement in theoretical knowledge pertaining to the course objectives was 8.23 on a 0 to 10 scale, and 8.25 for practical skills. Greatest improvement was in advanced airway management, physiological reactions to hypothermia, pneumothorax interventions, special considerations for patients injured by explosives (eg, blast injuries and burns), and medical decision making during an active shooter scenario. The evaluation of the simulation exercises received high marks (mean rating 4.53 [3.92-4.92] out of 5.0) on all aspects. The participants rated the overall course quality at 4.67 (on a 0 to 5 scale), with the simulations, practical exercises, and the structure of moving from theory to practice being mentioned as particularly positive.Conclusion: Overall, the results showed that the APTC course received high marks on almost all measured factors. Further validation of the questionnaires is needed before general implementation of the battery can be recommended. Such implementation would benefit diverse course development and quality assurance
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40.
  • Prytz, Erik, 1985-, et al. (författare)
  • Evaluating the Effect of Bleeding Control Kit Locations for a Mass Casualty Incident Using Discrete Event Simulation
  • 2020
  • Ingår i: Proceedings of the 17th ISCRAM Conference. - : Information Systems for Crisis Response and Management. - 9781949373271 ; , s. 167-178
  • 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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41.
  • Prytz, Erik, 1985-, et al. (författare)
  • First and Immediate Responders : Current capability needs and research challenges
  • 2019
  • Ingår i: Proceedings of the Human Factors and Ergonomics Society Annual Meeting. ; , s. 640-641
  • 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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42.
  • Prytz, Erik, 1985-, et al. (författare)
  • Fixation Differences in Visual Search of Accident Scenes by Novices and Expert Emergency Responders
  • 2018
  • Ingår i: Human Factors. - : Sage Publications. - 0018-7208 .- 1547-8181. ; 60:8, s. 1219-1227
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective:We sought to investigate whether expert–novice differences in visual search behavior found in other domains also apply to accident scenes and the emergency response domain.Background:Emergency service professionals typically arrive at accidents only after being dispatched when a civilian witness has called an emergency dispatch number. Differences in visual search behavior between the civilian witness (usually a novice in terms of emergency response) and the professional first responders (experts at emergency response) could thus result in the experts being given insufficient or erroneous information, which would lead them to arrive unprepared for the actual situation.Method:A between-subjects, controlled eye-tracking experiment with 20 novices and 17 experts (rescue and ambulance service personnel) was conducted to explore expert–novice differences in visual search of accident and control images.Results:The results showed that the experts spent more time looking at task-relevant areas of the accident images than novices did, as predicted by the information reduction hypothesis. The longer time was due to longer fixation durations rather than a larger fixation count.Conclusion:Expert–novice differences in visual search are present in the emergency domain. Given that this domain is essential to saving lives and also relies heavily on novices as the first link in the chain of response, such differences deserve further exploration.Application:Visual search behavior from experts can be used for training purposes. Eye-tracking studies of novices can be used to inform the design of emergency dispatch interviews.
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43.
  • Prytz, Erik, 1985-, et al. (författare)
  • Projekt Säker Patientvård Under Transport (SPURT)
  • 2023
  • Ingår i: Framtidens Skadeplats 2023. - Linköping : Linköping University Electronic Press. - 9789180751278 - 9789180751261
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Ambulanspersonal, och annan prehospital vårdpersonal, arbetar i en krävande och farlig miljö, och löper risk för både traumatiska skador (t.ex. trafikolyckor) och långsiktiga hälsoeffekter. Organisationsförändringar i den svenska sjukvården har lett till centralisering av resurser till färre och mer specialiserade, men därför också mer avlägsna, sjukhus. Det innebär ökade transportavstånd och att fler medicinska ingrepp måste utföras under transporten. Sjukvårdssystemet är särskilt beroende av vård under transport i större kriser och katastrofer. I dessa överstiger vårdbehovet per definition de tillgängliga medicinska resurserna. En del av hanteringen av sådana kriser går ut på att fördela patienter mellan sjukhus och andra vårdinrättningar på ett sådant sätt att inget enskilt sjukhus får ett ohanterligt inflöde av patienter. I sådana situationer kan det förekomma att även svårt skadade patienter får en längre transportsträcka än vad som är önskvärt, eftersom de måste fördelas till sjukhus som är mer avlägsna skadehändelsen.Projektet SPURT kommer etablera en forskningsplattform som kan användas för att nå en fördjupad kunskap om arbetsmiljö, säkerhet och arbetskvalitet för ambulanspersonal och annan personal som utför vård under transport.  Den centrala komponenten i plattformen kommer att vara en internationellt unik ambulanssimulator med rörelseplattform som inkluderar både den främre förarmiljön och den bakre vårdmiljön i en ambulans. Rörelseplattformen som kommer användas är Sim III. Sim III har ett linjärt rörelsesystem som medger rörelse i fyra frihetsgrader, och erbjuder både linjär- och lutningsrörelse. Genom att koppla samman slädens förflyttning med fordonets sidoposition, skapar simulatorns rörelsealgoritm realistiska sidorörelser. Utöver de yttre rörelsesystemen har Sim III även ett separat skakbord som rör kabinen relativt projektionsytan. 
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44.
  • Prytz, Erik, 1985-, et al. (författare)
  • The effect of moulage on immersion, realism and learning in a traffic accident training scenario for police, rescue service and ambulance students
  • 2019
  • Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:1, s. 17-18
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction:Moulage is the art of creating faked injuries on actors for training purposes. Moulage is commonly used in disaster and emergency medicine training, as it is believed to improve learning through enhanced realism.Aim:The aim of the current study was to test the effect of moulage on perceived realism and learning during a joint exercise featuring students from the police, rescue service, and ambulance service.Methods:The scenario was a car accident with two victims. Students (n = 135) were divided into 12 groups. Moulage was applied to the victim actors for half the groups (n = 67), whereas the other half (n = 68) experienced the scenario without moulage. Victim cards were used in both scenarios. Immersion, realism, and learning was measured on a 100-point scale immediately post-scenario using a questionnaire.Results:Two (moulage group) by three (student population and police, rescue service, or ambulance) ANOVAS on realism, immersion, and learning found no effects on realism or immersion (all p>0.10). There was an effect of student group on learning, F(2, 92) = 3.518, p = 0.034, partial eta square = 0.071, such that the rescue service students had overall lower scores on learning (M = 53.87, SD = 28.29) compared to the police (M = 66.07, SD = 27.55) and ambulance students (M = 74.99, SD = 24.51). Cohen’s ds for moulage effect was calculated to 0.144 for immersion, 0.112 for realism, and 0.003 for learning.Discussion:The current study did not find any effects of moulage on immersion, realism, or learning. The effect sizes indicate that any effect of moulage on realism and immersion, should it exist, is in the approximate size of 2-3 points on a 100-point scale. The lack of effect may be due to limitations in the study design, but may also indicate that the use of moulage in addition to victim cards is not necessarily beneficial for novice students’ learning.
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45.
  • Prytz, Erik, 1985-, et al. (författare)
  • Tillbaka till Framtidens Skadeplats : Scenarier och resultat
  • 2021
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna rapport presenterar ett nytt kunskapsläge om framtidens skadeplats utifrån de resultat som kommit från forskningsprogrammet Effektiva räddningsinsatser på Framtidens Skadeplats 2015–2020. Rapporten är en omarbetad version baserad på rapporten Att hantera framtidens skadeplatser: scenarier och utgångspunkter för kunskapsutveckling runt räddningsinsatser och skadeplatsarbete som gavs ut av Centrum för forskning inom respons- och räddningssystem (CARER) 2016. I den rapporten presenterades ett underlag för de kommande aktiviteterna som var planerade att genomföras inom forskningsprogrammet. Rapporten beskrev också åtta olika skadeplatsscenarier som togs fram i linje med Myndigheten för samhällsskydd och beredskaps (MSB:s) dåvarande framtidsanalyser samt en analys av då tillgänglig litteratur om olyckor och katastrofer. Dessa scenarier beskrev på ett strukturerat och detaljerat sätt möjliga framtida skadeplatser av särskilt intresse ur ett praktiker- och forskningsperspektiv. I denna rapport har dessa åtta scenarier arbetats om och uppdaterats utifrån rådande läge i samhället i dag. De har också utökats med en beskrivning av en möjlig respons så som den kan se ut i framtiden inom tidsramen 10 till 15 år. Denna rapport innehåller också en övergripande beskrivning av de resultat som framkommit från de sex arbetspaketen (AP) i programmet. Inom AP2 redovisas teman om a) frivilliga och civila insatspersoner, b) semi-professionella som första insatsaktörer, c) genus, etnicitet och utsatthet, samt d) efterforskning av försvunna personer. AP3 redovisar teman om a) effektiv utlarmning av frivilliga och semiprofessionella resurser, b) prediktering, c) skadeplatslogistik, samt d) alarmering och effektivare räddningstjänst. AP4 går igenom a) IT-plattformen OP-SENS och b) lägesbilder, medan AP5 redovisar teman om a) utvärdering av ny teknik, b) utvärdering av utbildning och övning, samt c) utvärdering av ny metodik. Slutligen har AP6 redovisat teman om a) nya metoders och resurser effekt på systemnivå, samt b) värdering av frivilliga och semiprofessionella. Dessa forskningsresultat återkommer i scenarierna för att exemplifiera hur de kan omsättas i praktiskt skadeplatsarbete innan, under och efter en insats.
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46.
  • Prytz, Erik, 1985-, et al. (författare)
  • Utveckling av ett svenskt utbildningskoncept utifrån det amerikanska konceptet Stop the Bleed
  • 2019
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Inom ramen för denna studie har ett utbildningskoncept för första-hjälpen åtgärder vid livshotande blödning utvecklats utifrån det amerikanska konceptet "Stop the bleed". Utbildningen riktar sig till räddningstjänstpersonal och har validerats i en pilotutbildning. Utbildningskonceptet kan ligga till grund för en nationellt likriktad och kvalitetssäkrad utbildning av blödningskontrollerande åtgärder för räddningstjänstpersonal.
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47.
  • Prytz, Erik, 1985-, et al. (författare)
  • What motivates and demotivates emergency response volunteers? A survey-based factor analysis study
  • 2023
  • Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BMC. - 1757-7241. ; 31:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundOrganized volunteer initiatives can reduce response times and improve outcomes in emergencies such as cardiac arrests or fires. Retention of volunteers is important to maintain good coverage and capabilities. The current study explores factors underlying volunteers motivation to continue as volunteers.MethodsData from 5347 active volunteers were collected through an online survey. An exploratory factor analysis was used to identify underlying factors that were then used in a regression analysis to predict intention to continue as a volunteer. Group differences based on, among others, number of alarms and prior professional experience in emergency response were explored.ResultsThe results showed that the factors community, self-image, and competence were the strongest positive predictors for the motivation to continue, whereas alarm fatigue and negative experience were the strongest negative predictors. Volunteers with professional background had higher competence and lower Alarm fatigue. Volunteers from rural areas and small cities had higher community than those in large cities.ConclusionsAlarm fatigue can make it hard to retain volunteers, which could be addressed using improved dispatch algorithms. Support after dispatch is important to prevent negative experiences. Finally, increased competence, e.g. through education and training, can improve volunteers motivation to continue.
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48.
  • Prytz, Erik, 1985- (författare)
  • Workload transitions and stress : changes over time
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Workload transitions are situations where operators are suddenly confronted with levels of workload substantially different from previously established levels. Workload transitions may affect the operators' state of stress and coping behaviors but previous research has not conclusively demonstrated the nature of those. The first goal of the current work was to investigate the discrepant findings of the previous literature. Two experiments were conducted where participants were asked to perform a digit detection task that suddenly shifted between low and high event rates (i.e., low and high workload, respectively). The first experiment used a large magnitude transition that resulted in a decrease in reported levels of task engagement and effort. Over time, the reported stress and workload ratings of the transitioned groups approached the nontransitioned control groups. A second experiment was conducted using a moderate magnitude transition. This second experiment replicated the findings from the first experiment, with the key difference being that the transition from a low to more a more moderate level of workload resulted in higher, sustained task engagement and effort. Two main conclusions are drawn from these results. First, over time the stress and workload levels of individuals who experience a transition will approach those reported by nontransitioned individuals. Future workload transition research must therefore consider the effect of the time from transition. Second, the magnitude of the transition may influence the coping response such that a moderate transition may result in increased task-oriented, effortful coping whereas a large magnitude transition may result in decreased effortful coping. 
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49.
  • Rybing, Jonas, 1987- (författare)
  • Studying Simulations with Distributed Cognition
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Simulations are frequently used techniques for training, performance assessment, and prediction of future outcomes. In this thesis, the term “human-centered simulation” is used to refer to any simulation in which humans and human cognition are integral to the simulation’s function and purpose (e.g., simulation-based training). A general problem for human-centered simulations is to capture the cognitive processes and activities of the target situation (i.e., the real world task) and recreate them accurately in the simulation. The prevalent view within the simulation research community is that cognition is internal, decontextualized computational processes of individuals. However, contemporary theories of cognition emphasize the importance of the external environment, use of tools, as well as social and cultural factors in cognitive practice. Consequently, there is a need for research on how such contemporary perspectives can be used to describe human-centered simulations, re-interpret theoretical constructs of such simulations, and direct how simulations should be modeled, designed, and evaluated.This thesis adopts distributed cognition as a framework for studying human-centered simulations. Training and assessment of emergency medical management in a Swedish context using the Emergo Train System (ETS) simulator was adopted as a case study. ETS simulations were studied and analyzed using the distributed cognition for teamwork (DiCoT) methodology with the goal of understanding, evaluating, and testing the validity of the ETS simulator. Moreover, to explore distributed cognition as a basis for simulator design, a digital re-design of ETS (DIGEMERGO) was developed based on the DiCoT analysis. The aim of the DIGEMERGO system was to retain core distributed cognitive features of ETS, to increase validity, outcome reliability, and to provide a digital platform for emergency medical studies. DIGEMERGO was evaluated in three separate studies; first, a usefulness, usability, and facevalidation study that involved subject-matter-experts; second, a comparative validation study using an expert-novice group comparison; and finally, a transfer of training study based on self-efficacy and management performance. Overall, the results showed that DIGEMERGO was perceived as a useful, immersive, and promising simulator – with mixed evidence for validity – that demonstrated increased general self-efficacy and management performance following simulation exercises.This thesis demonstrates that distributed cognition, using DiCoT, is a useful framework for understanding, designing and evaluating simulated environments. In addition, the thesis conceptualizes and re-interprets central constructs of human-centered simulation in terms of distributed cognition. In doing so, the thesis shows how distributed cognitive processes relate to validity, fidelity, functionality, and usefulness of human-centered simulations. This thesis thus provides a new understanding of human-centered simulations that is grounded in distributed cognition theory.
  •  
50.
  • Strauss-Riggs, Kandra, et al. (författare)
  • Recommended Process Outcome Measures for Stop the Bleed Education Programs
  • 2021
  • Ingår i: AEM Education and Training. - : John Wiley and Sons Inc.. - 2472-5390. ; 5:1, s. 139-142
  • 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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