We chose to specifically address a suite of hemorrhage control techniques in our simulation, as these skills are often taught by direct observation, without appropriate feedback on the application of appropriate pressure. Successful use of tourniquets, for example, often require higher-than-expected amounts of pressure. Baruch et al noted a "confidence-competence mismatch" when observing non-medical users applying tourniquets and investigating reasons for failure. They report that a common reason for tourniquet failure in this group of users is retention of too much slack in the straps and too few turns of the windlass, as a result of inadequate assessment of the amount of pressure required to successfully deploy the tourniquet. In our model, sensors will measure the pressure applied to assess adequacy of compression. We will also use pump-based active fluid technology to generate visual feedback of the adequacy of compression. Our system will provide quantitative feedback on pressure, as well as visual feedback based on arresting the 'hemorrhage' of the fluid. The use of a dynamic model that actively simulates bleeding, and provides both visual and quantitative feedback for the trainee, addresses the shortcomings of a standard training model for hands-on tourniquet application, and may result in fewer tourniquet failures due to inadequate compression.
Inadequate or incomplete training leads to poor hemorrhage control techniques and, ultimately, ongoing bleeding and preventable death. Practice in hemorrhage control has been shown to be effective, especially for advanced maneuvers which include tourniquet application. Untrained personnel was found to have unacceptably high rates of tourniquet failure when given tourniquets to deploy without any additional training aside from package instructions. These findings confirm that formalized training and hands-on practice is essential.
Pressure[edit | edit source]
In this module, you will learn how to stop the bleeding by applying pressure.
Packing[edit | edit source]
In this module, you will learn how to stop the bleeding by applying packing.
Tourniquet[edit | edit source]
In this module, you will learn how to stop the bleeding by applying a tourniquet.
Foley[edit | edit source]
In this module, you will learn how to stop the bleeding by using a foley.
References[edit | edit source]
- Baruch EN, Kragh JF Jr, Berg AL, Aden JK Rd, Benov A, Shina A, Shlaifer A, Ahimor A, Glassberg E, Yitzhak A. Confidence-Competence Mismatch and Reasons for Failure of Non Medical Tourniquet Users. Prehosp Emerg Care. 2017 Jan-Feb;21(1):39-45. doi: 10.1080/10903127.2016.1209261. Epub 2016 Aug 5. PMID: 27494564.
- Baruch EN, Benov A, Shina A, Berg AL, Shlaifer A, Glassberg E, Aden JK 3rd, Bader T, Kragh JF Jr, Yitzhak A. Does practice make perfect? Prospectively comparing effects of 2 amounts of practice on tourniquet use performance. Am J Emerg Med. 2016 Dec;34(12):2356-2361. doi: 10.1016/j.ajem.2016.08.048. Epub 2016 Aug 27. PMID: 27614373.
- Dennis A, Bajani F, Schlanser V, Tatebe LC, Impens A, Ivkovic K, Li A, Pickett T, Butler C, Kaminsky M, Messer T, Starr F, Mis J, Bokhari F. Missing expectations: Windlass tourniquet use without formal training yields poor results. J Trauma Acute Care Surg. 2019 Nov;87(5):1096-1103. doi: 10.1097/TA.0000000000002431. PMID: 31274827.