A Novel, Perfused-Cadaver Simulation Model for Tourniquet Training in Military Medics

Grabo, Daniel; Polk, Travis M.; Strumwasser, Aaron; Inaba, Kenji; Foran, Christopher; Luther, Chase; Minneti, Michael; Kronstedt, Shane; Wilson, Alison; Δημητριάδης, Δημήτριος

doi:10.55460/3q37-3p0a

Cited by 14 publications

(7 citation statements)

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“…Prior studies from the senior authors demonstrate the utility of fresh tissue training in teaching military medics lifesaving procedures such as needle decompression for tension pneumothorax and limb tourniquet application 10,13 . The SOCT combat casualty care course at our institution, however, is comprehensive.…”

Section: Discussionmentioning

confidence: 99%

“…A blood substitute consisting of water and non-toxic red paint was used. Simulated blast, gunshot wounds, and burns were created using moulage or actual tissue manipulation 10 …”

Section: Methodsmentioning

confidence: 99%

“…Simulated blast, gunshot wounds, and burns were created using moulage or actual tissue manipulation. 10 A "low-light" environment is created whereby students operate using headlamps and minimal pass-through lighting from covered windows. Simulated patients or cadavers are placed respectfully around the room, and the students must render care in the location in which they encounter the simulated casualty.…”

Section: Methodsmentioning

confidence: 99%

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Initial report on special operations clinical training at a civilian academic medical center

Oury

Reed

Donovan

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND Military-civilian partnerships for combat casualty care skills training have mostly focused on traditional, combat surgical team training. We sought to better understand US Special Forces (SF) Medics' training at West Virginia University in Morgantown, West Virginia, a Level 1 trauma center, via assessments of medical knowledge, clinical skills confidence, and technical performance. METHODS Special Forces Medics were evaluated using posttraining medical knowledge tests, procedural skills confidence surveys (using a 5-point Likert scale), and technical skills assessments using fresh perfused cadavers in a simulated combat casualty care environment. Data from these tests, surveys, and assessments were analyzed for 18 consecutive SF medic rotations from the calendar years 2019 through 2021. RESULTS A total of 108 SF Medics' tests, surveys, and assessments were reviewed. These SF Medics had an average of 5.3 years of active military service; however, deployed experience was minimal (73% never deployed). Review of knowledge testing demonstrated a slight increase in mean test score between the precourse (80% ± 14%; range, 50–100%) when compared with the postcourse (82% ± 14%; range, 50–100%). Skills confidence scores increased between courses, specifically within the point of injury care (p = 0.09) and prolonged field care (p < 0.001). Technical skills assessments included cricothyroidotomy, chest tube insertion, and tourniquet placement. CONCLUSION This study provides preliminary evidence supporting military-civilian partnerships at an academic Level 1 trauma center to provide specialty training to SF Medics as demonstrated by increase in medical knowledge and confidence in procedural skills. Additional opportunities exist for the development technical skills assessments. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.

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Section: Discussionmentioning

confidence: 99%

“…A blood substitute consisting of water and non-toxic red paint was used. Simulated blast, gunshot wounds, and burns were created using moulage or actual tissue manipulation 10 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Initial report on special operations clinical training at a civilian academic medical center

Oury

Reed

Donovan

et al. 2023

J Trauma Acute Care Surg

Self Cite

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“…Human volunteer studies among larger and more heterogenous populations, could potentially evaluate the effectiveness of the technique when applied on individuals with different body habitus or by providers with limited prior knowledge and training in hemorrhage control. The efficacy of the technique, along with feedback for trainees could potentially be examined in perfused cadaver studies, as has been described with tourniquets 23 . Finally, the technique must also be empirically compared to alternatives such as kneeling on the femoral triangle or applying forceful direct pressure to junctional areas using other techniques.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of the technique, along with feedback for trainees could potentially be examined in perfused cadaver studies, as has been described with tourniquets. 23 Finally, the technique must also be empirically compared to alternatives such as kneeling on the femoral triangle or applying forceful direct pressure to junctional areas using other techniques.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of the manual pressure points technique for hemorrhage control—The 2022 THOR pre‐conference meeting experience

Thompson¹,

Glassberg

Alon

et al. 2023

Transfusion

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Introduction Limb and junctional hemorrhage are leading causes of potentially preventable death among trauma casualties. Hemorrhage control for these regions could be achieved by direct or indirect pressure. The manual pressure points (MPP) involves applying manual pressure on the arterial supply to occlude distal blood flow without the need for specialized equipment. Study Design and Methods Prospective, non‐randomized, human volunteer, controlled environment study involving 38 healthy military caregivers, with 26 participants attending a short instructional session. During a medical exercise, participants were requested to apply pressure on the supraclavicular and femoral points aiming to stop regional blood flow, measured by distal pulse palpation. The measures recorded included achievement of distal pulse cessation, success in achieving cessation for a full minute, and subjects' pain scores reported after each attempt. Results All participants succeeded in achieving distal pulse cessation for both the supraclavicular and femoral points for a full minute. The median time to initial success was 3.0 (interquartile range 2.0–5.0) seconds in the supraclavicular point and 4.5 (interquartile range 3.0–6.0) seconds in the femoral point. Pain scores ranging between 0 and 3 were reported by most subjects during supraclavicular (68.4%) and femoral occlusion (84.2%). Conclusion The MPP technique was highly effective in occluding distal palpable pulses in healthy volunteers when applied to the supraclavicular and femoral arteries. Brief instruction on the technique can potentially improve the chances of achieving hemorrhage control within 5 s. Further research is required to determine efficacy among different populations and providers with varying experience levels.

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Advancing the Education of Stop the Bleed: Development of a Perfused Synthetic Cadaver Model

Gupta

Villegas

Rosenberg

et al. 2019

Journal of Surgical Research

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A Novel, Perfused-Cadaver Simulation Model for Tourniquet Training in Military Medics

Cited by 14 publications

References 0 publications

Initial report on special operations clinical training at a civilian academic medical center

Initial report on special operations clinical training at a civilian academic medical center

The effectiveness of the manual pressure points technique for hemorrhage control—The 2022 THOR pre‐conference meeting experience

Advancing the Education of Stop the Bleed: Development of a Perfused Synthetic Cadaver Model

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