An Experimental Predeployment Training Program Improves Self-Reported Patient Treatment Confidence andPreparedness of Army Combat Medics

Gerhardt, Robert T.; Hermstad, Erik; Oakes, Michael; Wiegert, Richard S; Oliver, Jeffrey W.

doi:10.1080/10903120802101058

Cited by 17 publications

(10 citation statements)

References 6 publications

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“…Advanced Trauma Life Support (ATLS) [17,18], Prehospital Trauma Life Support (PHTLS) [13,22], and International Trauma Life Support (ITLS) [15,23], all of which are integrated into regional air and ground emergency networks, logistic and technical providers, emergency call operators, hospitals, and other medical service providers. Most authors attribute improvement of trauma care performance or outcome indicators to continuous medical education [16], while trauma registries and other injury surveillance instruments are considered the backbone of quality management and scientific evaluation [24].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, and despite reported improvement of "soft" parameters (e.g. self-reported confidence, level of preparedness, knowledge) the scientific evidence for improved objective trauma outcomes through employment of such algorithms is still missing [13-15,17,18]. When the specific alpine setting is concerned, recent studies indicate a great disparity of medical training status amongst mountain rescuers [25].…”

Section: Discussionmentioning

confidence: 99%

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Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Hasler

Schmucker

Evangelopoulos

et al. 2011

J Trauma Manage Outcomes

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BackgroundInjuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. In the alpine setting, early assessment of injury and health status is essential for the initiation of adequate means of care and transport. Nevertheless, validated standardized protocols for on-slope triage are missing. This article can assist in understanding the characteristics of injured winter sportsmen and exigencies for future on-slope triage protocols.MethodsSix-year review of trauma cases in a tertiary trauma centre. Consecutive inclusion of all injured skiers and snowboarders aged >15 (total sample) years with predefined, severe injury to the head, spine, chest, pelvis or abdomen (study sample) presenting at or being transferred to the study hospital. Descriptive analysis of age, gender and injury pattern.ResultsAmongst 729 subjects (total sample) injured from skiing or snowboarding, 401 (55%, 54% of skiers and 58% of snowboarders) suffered from isolated limb injury. Amongst the remaining 328 subjects (study sample), the majority (78%) presented with monotrauma. In the study sample, injury to the head (52%) and spine (43%) was more frequent than injury to the chest (21%), pelvis (8%), and abdomen (5%). The three most frequent injury combinations were head/spine (10% of study sample), head/thorax (9%), and spine/thorax (6%). Fisher's exact test demonstrated an association for injury combinations of head/thorax (p < 0.001), head/abdomen (p = 0.019), and thorax/abdomen (p < 0.001).ConclusionThe data presented and the findings from previous investigations indicate the need for development of dedicated on-slope triage protocols. Future research must address the validity and practicality of diagnostic on-slope tests for rapid decision making by both professional and lay first responders. Thus, large-scale and detailed injury surveillance is the future research priority.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Hasler

Schmucker

Evangelopoulos

et al. 2011

J Trauma Manage Outcomes

View full text Add to dashboard Cite

show abstract

“…None of these advancements would make any difference, however, were it not for the regular and realistic training conducted by military medical and non-medical personnel. Training allows military medicine to overcome many of the inherent barriers to trauma care in a combat setting, such as the lack of cross-matched blood products, the need to perform care while under fire, and limited availability of surgical resources [35][36][37].…”

Section: Military Versus Civilian Responsementioning

confidence: 99%

Blurred front lines: triage and initial management of blast injuries

Balazs

Blais

Bluman

et al. 2015

Curr Rev Musculoskelet Med

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Recent armed conflicts and the expanded reach of international terror groups has resulted in an increased incidence of blast-related injuries in both military and civilian populations. Mass-casualty incidents may require both on-scene and in-hospital triage to maximize survival rates and conserve limited resources. Initial evaluation should focus on the identification and control of potentially life-threatening conditions, especially life-threatening hemorrhage. Early operative priorities for musculoskeletal injuries focus on the principles of damage-control orthopaedics, with early and aggressive debridement of soft-tissue wounds, vascular shunting or grafting to restore limb perfusion, and long-bone fracture stabilization via external fixation. Special considerations such as patient transport, infection control and prevention, and amputation management are also discussed. All orthopedic surgeons, regardless of practice setting, should be familiar with the basic principles of evaluation, resuscitation, and initial management of explosive blast injuries.

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“…I studie I observerade sjuksköterskan att sjukvårdarna under insats inte alltid vidtog nödvändiga åtgärder för att förbättra den skadades situation. Det råder delade meningar om det finns ett samband mellan högt självförtroende och förmågan att utföra en åtgärd i verkligheten (Gerhardt et al, 2008;Sergeev et al, 2012). Det kan vara av vikt att inte ge sjukvårdarna för stort ansvar, eftersom det kan skapa en osäkerhet som gör att de inte kan fokusera på det som är mest elementärt för den rådande situationen.…”

Section: Lärandet Under Förberedelseskedetunclassified

Militär akutsjukvård i fält : när den övade verkligheten blir verklig

Andersson¹

2014

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Aims: Governing for the Armed Forces health care is respect for human dignity and the view of each individual as irreplaceable. The quality of the military care will be at a level equivalent to that of today's civil peace healthcare, which requires that the training is of high quality. Casualty care in the military environment is a complex, challenging and dangerous task. Today there is a lack of knowledge about how to learn these skills. The purpose of the research was to identify the knowledge area pre-hospital care in the military environment by examining what doctors, nurses, paramedics and officers learn about military health care during preparation and exercise. Method: A phenomenographic approach was used in all sub-studies, and empirical data were collected by means of semi-structured interviews. Study I‐III are cross-sectional studies and study IV is a longitudinal study. Twelve registered nurses who had served in Bosnia were interviewed for study I, and 24 conscript paramedics were interviewed for study II. Study III included 20 officers in their pre-deployment training for service in Afghanistan and Liberia, and Study IV included 7 doctors and twenty nurses who previously had served in Afghanistan, Bosnia, Kosovo and Liberia. Results: Learning military health care by training and gaining experience can be seen as different abilities; interaction, action and reflection. In-depth analysis at a meta--‐level revealed that the integration between the military and military medical fields of knowledge was missing. The results indicate that participants' understanding of their respective fields of knowledge is inadequate and needs to be integrated in education in a clearer way. Implications: To create opportunities for better education and integration in these fields of knowledge are proposed (1) that the findings of the thesis could be utilised to develop the design of the curriculum (2) the inter-professional learning is introduced as a part of creating a safer and more effective pre-hospital care, (3) the clinical competence becomes part of the development of pre-hospital emergency care in the field, and (4) that the training is built according to the principle of "train as you fight" with emphasis on the requirements in the combat zone

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An Experimental Predeployment Training Program Improves Self-Reported Patient Treatment Confidence andPreparedness of Army Combat Medics

Cited by 17 publications

References 6 publications

Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Blurred front lines: triage and initial management of blast injuries

Militär akutsjukvård i fält : när den övade verkligheten blir verklig

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