Hemorrhage-Control Training in Medical Education

Gowen, Jared T; Sexton, Kevin W.; Thrush, Carol R.; Privratsky, Anna; Beck, William C.; Taylor, John Russell; Davis, Ben; Kimbrough, Mary K.; Jensen, Hanna; Robertson, Ronald D.; Bhavaraju, Avi

doi:10.1177/2382120520973214

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…48 Similarly, incorporating STB training within formal educational curriculum has shown students to have increased comfort and confidence. 49 Diverse financial avenues further secured long-term sustenance of PLSP as shown by a systematic review highlighting the importance of combined community, service and system-level funding models. 42 The methodology described provides a structural framework which could be replicated within other similar settings while implementing a community-based healthcare intervention.…”

Section: Discussionmentioning

confidence: 99%

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control

Merchant,

Hassan,

Baig

et al. 2023

Trauma Surg Acute Care Open

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BackgroundOut-of-hospital cardiac arrest (OHCA) and life-threatening bleeding from trauma are leading causes of preventable mortality globally. Early intervention from bystanders can play a pivotal role in increasing the survival rate of victims. While great efforts for bystander training have yielded positive results in high-income countries, the same has not been replicated in low and middle-income countries (LMICs) due to resources constraints. This article describes a replicable implementation model of a nationwide program, aimed at empowering 10 million bystanders with basic knowledge and skills of hands-only cardiopulmonary resuscitation (CPR) and bleeding control in a resource-limited setting.MethodsUsing the EPIS (Exploration, Preparation, Implementation and Sustainment) framework, we describe the application of a national bystander training program, named ‘Pakistan Life Savers Programme (PLSP)’, in an LMIC. We discuss the opportunities and challenges faced during each phase of the program’s implementation and identify feasible and sustainable actions to make them reproducible in similar low-resource settings.ResultsA high mortality rate owing to OHCA and traumatic life-threatening bleeding was identified as a national issue in Pakistan. After intensive discussions during the exploration phase, PLSP was chosen as a potential solution. The preparation phase oversaw the logistical administration of the program and highlighted avenues using minimal resources to attain maximum outreach. National implementation of bystander training started as a pilot in suburban schools and expanded to other institutions, with 127 833 bystanders trained to date. Sustainability of the program was targeted through its addition in a single national curriculum taught in schools and the development of a cohesive collaborative network with entities sharing similar goals.ConclusionThis article provides a methodological framework of implementing a national intervention based on bystander response. Such programs can increase bystander willingness and confidence in performing CPR and bleeding control, decreasing preventable deaths in countries having a high mortality burden.Level of evidenceLevel VI.

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Section: Discussionmentioning

confidence: 99%

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control

Merchant,

Hassan,

Baig

et al. 2023

Trauma Surg Acute Care Open

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“…Therefore, this simulator will have a positive impact on those trainings. Additionally, there are other publications that focuses on how to manage hemorrhagic lesions by clinicians [ 28 , 41 , 42 ]. In those papers, simulation is presented as a tool that supports learning on the management of hemorrhagic lesions.…”

Section: Discussionmentioning

confidence: 99%

Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Larraga-García

Pérez-Jiménez

Ros-Dopico

et al. 2021

Sensors

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One of the main preventable leading causes of death after a trauma injury is the hemorrhagic shock. Therefore, it is extremely important to learn how to control hemorrhages. In this paper, a hemorrhagic trauma simulator for lower limb has been developed and a pilot study has been accomplished to trail the simulator. Four different bleeding scenarios have been tested per participant, gathering information about the manual pressure exerted to control the bleeding. Data, altogether, from 54 hemorrhagic scenarios managed by final year medical students and doctors were gathered. Additionally, a post-simulation questionnaire, related to the usability of the simulator, was completed. All the participants managed to control the simulated bleeding scenarios, but the pressure exerted to control the four different scenarios is different depending if the trainee is a student or a doctor, especially in deep venous hemorrhages. This research has highlighted the different approach to bleeding control treatment between medical students and doctors. Moreover, this pilot study demonstrated the need to deliver a more effective trauma treatment teaching for hemorrhagic lesions and that hemorrhagic trauma simulators can be used to train and evaluate different scenarios.

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“…The experimental group was taught using the PTEBL teaching method combined with the use of Caesar, and the control group was taught using the traditional teaching method. Based on the Likert scale and in reference to prior studies [ 19 ], a questionnaire (see Additional file 1 and Additional file 2 ) was administered before and after class. The students were asked about their willingness to rescue a patient at the first scene of traumatic bleeding and their confidence in the three haemostatic skills.…”

Section: Methodsmentioning

confidence: 99%

“…The durations of the control and experimental group studies were standardized, and both were 4 h. A questionnaire was conducted before and after the course (see Additional file 1 and Additional file 2 ), and it addressed student confidence in STB skills, willingness to rescue at the trauma scene and evaluation of the course, etc., to evaluate the effect of teaching in the control group and the experimental group. The competencies needed for medical students in terms of specific standards were established on the basis of the latest International Medical Association guidelines and other related studies [ 19 – 25 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of two teaching methods for stopping the bleed: a randomized controlled trial

Chen

DiNenna

et al. 2022

BMC Med Educ

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Background The “Stop the Bleed” (STB) campaign has achieved remarkable results since it was launched in 2016, but there is no report on the teaching of an STB course combined with a trauma patient simulator. This study proposes the “problem-, team-, and evidence-based learning” (PTEBL) teaching method combined with Caesar (a trauma patient simulator) based on the STB course and compares its effect to that of the traditional teaching method among outstanding doctoral candidates training in haemostasis skills. Method Seventy-eight outstanding doctoral candidate program students in five and eight-year programs were selected as the research subjects and were randomly divided into a control group (traditional teaching method, n = 34) and an experimental group (PTEBL teaching method combined with Caesar, n = 44). Their confidence in their haemostasis skills and willingness to rescue injured victims were investigated before and after the course in both groups. Result Students’ self-confidence in their STB skills and the willingness to rescue improved after the class in both groups. Compared with the control group, students in the experimental group were more confident in compressing with bandages and compressing with a tourniquet after a class (compressing with bandages: control group 3.9 ± 0.8 vs. experimental group 4.3 ± 0.7, P = 0.014; compressing with a tourniquet: control group 3.9 ± 0.4 vs. experimental group 4.5 ± 0.8, P = 0.001) More students in the experimental group than the control group thought that the use of Caesar for scenario simulation could improve learning (control group 55.9% vs. experimental group 81.8%, P = 0.024), and using this mannequin led to higher teacher-student interaction (control group 85.3% vs. experimental group 97.7%, P = 0.042). The overall effectiveness of the teaching was better in the experimental group than in the control group (control group 85.3% vs. experimental group 97.7%, P = 0.042). There was a significant positive correlation between teacher-student interactions and the overall effectiveness of teaching (R = 1.000; 95% CI, 1.000–1.000; P < 0.001). Conclusion The PTEBL teaching method combined with Caesar can effectively improve student mastery of STB skills and overcome the shortcomings of traditional teaching methods, which has some promotional value in the training of outstanding doctoral candidates in STB skills.

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Hemorrhage-Control Training in Medical Education

Cited by 11 publications

References 13 publications

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control

Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study

Comparison of two teaching methods for stopping the bleed: a randomized controlled trial

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