A Randomized Trial of Mentored vs Nonmentored Military Medics Compared in the Application of a Wound Clamp Without Prior Training: When to Shut Up and Just Watch!

Autor: Kirkpatrick AW; Regional Trauma Services, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Department of Surgery, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Department of Critical Care Medicine, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Alberta Health Services, Foothills Medical Centre, 1403 29 St NW, Calgary, AB T2N 2T9.; Canadian Forces Health Services, 713 Montreal Road, Ottawa, ON K1G 0G6., Mckee JL; Department of Surgery, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9., Netzer I; Israeli Defense Force Medical Corp, 9 Yitzhak Rabin Blvd., Kiryat Ben-Gurion, Jerusalem 9103001, Israel., Mckee IA; City of Edmonton, 10351 96 St, Edmonton, AB T5H 2H5., McBeth P; Regional Trauma Services, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Department of Surgery, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Department of Critical Care Medicine, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Alberta Health Services, Foothills Medical Centre, 1403 29 St NW, Calgary, AB T2N 2T9., Wachs JP; Regenstrief Center for Healthcare Engineering, Gerald D. and Edna E. Mann Hall, Suite 225, 203 S. Martin Jischke Drive, West Lafayette, IN 47907-1971.; School of Industrial Engineering, Purdue University, 610 Purdue Mall, West Lafayette, IN 47907., Ball CG; Regional Trauma Services, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Department of Surgery, University of Calgary, 1403 29 St NW, Calgary, AB T2N 2T9.; Alberta Health Services, Foothills Medical Centre, 1403 29 St NW, Calgary, AB T2N 2T9., Glassberg E; Faculty of Medicine, Bar-Ilan University, Ramat Gan 5290002, Israel.
Jazyk: angličtina
Zdroj: Military medicine [Mil Med] 2020 Jan 07; Vol. 185 (Suppl 1), pp. 67-72.
DOI: 10.1093/milmed/usz251
Abstrakt: Introduction: Hemorrhage control is a basic task required of first responders and typically requires technical interventions during stressful circumstances. Remote telementoring (RTM) utilizes information technology to guide inexperienced providers, but when this is useful remains undefined.
Methods: Military medics were randomized to mentoring or not from an experienced subject matter expert during the application of a wound clamp (WC) to a simulated bleed. Inexperienced, nonmentored medics were given a 30-second safety briefing; mentored medics were not. Objective outcomes were time to task completion and success in arresting simulated bleeding.
Results: Thirty-three medics participated (16 mentored and 17 nonmentored). All (100%) successfully applies the WC to arrest the simulated hemorrhage. RTM significantly slowed hemorrhage control (P = 0.000) between the mentored (40.4 ± 12.0 seconds) and nonmentored (15.2 ± 10.3 seconds) groups. On posttask questionnaire, all medics subjectively rated the difficulty of the wound clamping as 1.7/10 (10 being extremely hard). Discussion: WC application appeared to be an easily acquired technique that was effective in controlling simulated extremity exsanguination, such that RTM while feasible did not improve outcomes. Limitations were the lack of true stress and using simulation for the task. Future research should focus on determining when RTM is useful and when it is not required.
(© Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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