Layperson Ability and Willingness to Use Hemostatic Dressings: A Randomized, Controlled Trial

Goolsby, Craig; Rojas, Luis; Moore, Krista; Kretz, Eric; Singletary, Eunice M.; Klimczak, Victoria; Charlton, Nathan P.

doi:10.1080/10903127.2019.1593566

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…The randomized study not included in these two reviews used modern virtual technology both in training and in the evaluation process and was, therefore, relevant. Twelve studies provided those evaluation methods to assess first aid skills other than CPR [15,25,27,[36][37][38][39][40][41][42][43][44].…”

Section: Resultsmentioning

confidence: 99%

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How to evaluate first aid skills after training: a systematic review

Minna

Hiltunen

Kärkkäinen

2022

Scand J Trauma Resusc Emerg Med

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Background To be able to help and save lives, laypersons are recommended to undergo first aid trainings. The aim of this review was to explore the variety of the elements of the measuring systems to assess the effects of first aid trainings on different aspects of first aid skills including practical skills, knowledge, and emotional perspectives. Methods This systematic literature review used Scopus and PubMed databases and searched for studies published between January, 2000, and December, 2020. Out of 2,162 studies meeting the search criteria, 15 studies with quantitative and repeatable evaluation methods to assess first aid skills after first aid training for adults were included in the final analysis. Results Practical skills, especially on the ability to perform cardiopulmonary resuscitation (CPR) and to use an automated external defibrillator, were the most studied first aid skills after first aid training. This evaluation was based on several standardized measurements and assessed often with the help of a combination of resuscitation manikin and observer. Evaluation methods of performance in other emergency situations are not well standardized. Questionnaires used to assess knowledge of first aid, though seemingly based on guidelines, were also not standardized, either. Emotional aspects of first aid (willingness or self-confidence) were evaluated by highly simplified questionnaires, and answers were graded by five-point Likert scale. Conclusion According to our review, the focus of evaluation methods after first aid training has been on practical skills and especially on CPR. Though the evaluation of first-aid knowledge seems to be straightforward, it is not performed systematically. Evaluation methods for emotional aspects are highly simplified. Overall, standardized measurements and evaluation methods to assess all aspects of first aid skills are needed.

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Section: Resultsmentioning

confidence: 99%

“…The only study of the use of hemostatic dressings in first aid relied on the subjective data provided by the observer and the digital data provided by a Z-medica simulator [ 38 ]. This simulator provided exact feedback only of the amount of pressure applied.…”

Section: Resultsmentioning

confidence: 99%

How to evaluate first aid skills after training: a systematic review

Minna

Hiltunen

Kärkkäinen

2022

Scand J Trauma Resusc Emerg Med

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“…A prior study evaluating the use of hemostatic dressings by laypeople demonstrated that the most common cause of unsuccessful dressing application was failure to apply pressure greater than 250 mmHg for the required amount of time [ 9 ]. Hemostatic dressings, recommended as adjunctive therapy to DMC, may decrease the time and pressure needed for DMC to stop life-threatening bleeding, helping to overcome the issue of rescuer fatigue [ 6 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hemostatic dressings, recommended as adjunctive therapy to DMC, may decrease the time and pressure needed for DMC to stop life-threatening bleeding, helping to overcome the issue of rescuer fatigue [ 6 , 16 ]. In addition, Goolsby et al demonstrated that a hemostatic dressing that does not rely on pressure applied by a rescuer resulted in fewer application errors compared to those dressings that require a rescuer to apply manual compression [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prior data suggest that a "CPR posture" using two interlocking hands with extended arms and body weight force is superior to other body positions used to deliver DMC [7,8]. However, a study evaluating laypeople's use of hemostatic dressings demonstrated that the primary cause of failure in a simulated model of life-threatening bleeding was the inability to maintain adequate direct pressure for three minutes [9]. Prior research demonstrates that in another manual lifesaving technique, chest compressions during cardiopulmonary resuscitation (CPR), quality degrades over time due to rescuer fatigue [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Provider Fatigue During Direct Manual Compression for Life-Threatening Bleeding

Charlton

Schuler²,

et al. 2021

Cureus

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IntroductionTrauma is a leading cause of death throughout the world, with hemorrhage being responsible for more than 35% of pre-hospital trauma deaths and more than 40% of deaths within the first 24 hours after injury. Despite first aid having a demonstrable effect on mortality from trauma, relatively little research has compared the best methods for bleeding control in the prehospital first aid setting. The most common firstline therapy for external bleeding control in the pre-hospital first aid setting is direct manual compression (DMC). However, a prior study demonstrated that the primary cause of failure in a simulated model of lifethreatening bleeding was the inability to maintain adequate direct pressure for three minutes. In this study, we evaluated the effect of fatigue on DMC for the duration of a typical urban emergency medical services (EMS) response time. MethodsWe conducted a prospective observational trial of 33 participants, 18 years of age or older to measure the pressure generated on a model of life-threatening bleeding over an eight-minute period using a "CPR posture" for applying pressure. The primary analyses were longitudinal two-level multilevel models (MLM) with repeated measures of outcome (i.e., CPR posture pressure) nesting within participants. The demographic factors of gender, age, and weight were included as moderators in the analyses and each was analyzed independently. ResultsThe participants' average age was 31 (SD = 11) and the average weight was 161 pounds (SD = 31). The sample consisted of 18 female participants (54.5%) and 15 male participants (45.5%). Applied DMC pressure declined over time, more sharply initially from the beginning to approximately 250 seconds, at which point the decrease in pressure was gradual. Of the demographic factors, gender was associated with a difference in cardiopulmonary resuscitation (CPR) posture pressure over time. ConclusionRescuers should be aware that fatigue may occur and may affect the quality of direct manual compression for control of life-threatening bleeding. Further research is needed to define the external pressures needed to control life-threatening bleeding and the extent that rescuer fatigue affects this pressure.

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A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

Matinrad

Reuter-Oppermann

2021

Cent Eur J Oper Res

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Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage–creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic–as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.

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Layperson Ability and Willingness to Use Hemostatic Dressings: A Randomized, Controlled Trial

Cited by 8 publications

References 18 publications

How to evaluate first aid skills after training: a systematic review

How to evaluate first aid skills after training: a systematic review

Provider Fatigue During Direct Manual Compression for Life-Threatening Bleeding

A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

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