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Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed"
Univ Nebraska Med Ctr, NE 68198 USA; Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.ORCID iD: 0000-0001-5943-0679
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2019 (English)In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 184, no 3-4, p. 28-36Article in journal (Refereed) Published
Abstract [en]

Objective

The American College of Surgeons (ACS) encourages clinicians to provide training to laypeople on tourniquet application. It is unclear whether clinicians are confident in their abilities and equipped with adequate knowledge, skills, and resources. This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions.

Methods

Thirty surgical trainees performed a tourniquet application simulation using a Combat Application Tourniquet and one of the three instructions sets developed by ACS, Department of Homeland Security, and the tourniquet manufacturer. Participants reported tourniquet knowledge, attitudes, and confidence and discussed the instructions. One instruction set was updated and compared to the original set with 20 new trainees.

Results

Participants with ACS instructions passed the greatest number of steps (p < 0.01) and completed the task significantly faster compared to those with manufacturer instructions (p < 0.01). Participants (80%) reported favorable views toward tourniquets but 30–60% did not align with to ACS tourniquet guidelines. Focus group participants suggested revisions to the ACS instructions. Comparing the original and revised version of these instructions resulted in no significant improvements.

Conclusions

ACS instructions provide guidance; however, improvements to tourniquet instruction are needed for success in controlling exsanguinating hemorrhage.

Place, publisher, year, edition, pages
Oxford University Press, 2019. Vol. 184, no 3-4, p. 28-36
Keywords [en]
Usability; Instructions; Hemorrhage
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-156576DOI: 10.1093/milmed/usy331ISI: 000462761100007PubMedID: 30901396Scopus ID: 2-s2.0-85063669938OAI: oai:DiVA.org:liu-156576DiVA, id: diva2:1315848
Conference
Military Health Sciences System Research Symposium (MHSRS)
Note

Funding Agencies|Office of the Secretary of Defense for Health Affairs

Available from: 2019-05-15 Created: 2019-05-15 Last updated: 2019-05-24Bibliographically approved

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Prytz, Erik

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Prytz, ErikJonson, Carl-Oscar
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Human-Centered systemsFaculty of Arts and SciencesDivision of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesCenter for Disaster Medicine and Traumatology
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Military medicine
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