A low-cost, DIY tourniquet simulator with built-in self-assessment for prehospital providers in Guatemala city.

Autor: Jhunjhunwala R; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA., Monzon J; Rafael Landivar University Guatemala City, Guatemala City, Guatemala., Faria I; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.; Federal University of Minas Gerais, Belo Horizonte, Brazil., Escalona G; Faculty of Medicine, Experimental Surgery and Simulation Center, Pontificia Universidad Católica de Chile, Santiago, Chile.; Hospital Sotero del Rio, Puente Alto, Chile., Zinco A; Hospital Sotero del Rio, Puente Alto, Chile., Ottolino P; Hospital Sotero del Rio, Puente Alto, Chile., Reyna F; Francisco Marroquin University, Guatemala City, Guatemala., Raykar N; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.; Brigham and Women's Hospital, Boston, Massachusetts, USA., Asturias S; Hospital Roosevelt, Ciudad de Guatemala, Guatemala.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Jun; Vol. 48 (6), pp. 1282-1289. Date of Electronic Publication: 2024 Mar 25.
DOI: 10.1002/wjs.12158
Abstrakt: Background: Hemorrhage is the leading cause of preventable death after trauma. In high-income countries first responders are trained in hemorrhage control techniques but this is not the case for developing countries like Guatemala. We present a low-cost training model for tourniquet application using a combination of virtual and physical components.
Methods: The training program includes a mobile application with didactic materials, videos and a gamified virtual reality environment for learning. Additionally, a physical training model of a bleeding lower extremity is developed allowing learners to practice tourniquet application using inexpensive and accessible materials. Validation of the simulator occurred through content and construct validation. Content validation involved subjective assessments by novices and experts, construct validation compared pre-training novices with experts. Training validation compared pre and post training novices for improvement.
Results: Our findings indicate that users found the simulator useful, realistic, and satisfactory. We found significant differences in tourniquet application skills between pre-training novices and experts. When comparing pre- and post-training novices, we found a significantly lower bleeding control time between the groups.
Conclusion: This study suggests that this training approach can enhance access to life-saving skills for prehospital personnel. The inclusion of self-assessment components enables self-regulated learning and reduces the need for continuous instructor presence. Future improvements involve refining the tourniquet model, validating it with first-responder end users, and expanding the training program to include other skills.
(© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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