Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-27T03:14:11.341Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of Cognitive Aids to Augment Point of Care Hemorrhage Control Skills in Laypersons

Published online by Cambridge University Press:  12 July 2023

Nicholas B. Dadario ,
Nicholas H. Shleiwet ,
Rachel C. Santana Felipes ,
Brennan Cook ,
Joseph V. Cooney ,
Karen M. Stephenson ,
Michelle Elsmore  and
Farrukh N. Jafri
Nicholas B. Dadario*
Affiliation:
Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
Nicholas H. Shleiwet
Affiliation:
Columbia University College of Dental Medicine, New York, New York, USA
Rachel C. Santana Felipes
Affiliation:
Department of Emergency Medicine, White Plains Hospital, White Plains, New York, New York, USA
Brennan Cook
Affiliation:
Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
Joseph V. Cooney
Affiliation:
Touro College of Osteopathic Medicine, Middletown, New York, USA
Karen M. Stephenson
Affiliation:
Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York, USA,
Michelle Elsmore
Affiliation:
Department of Biological Sciences, Binghamton University, Binghamton, New York, USA
Farrukh N. Jafri
Affiliation:
Department of Emergency Medicine, White Plains Hospital, White Plains, New York, New York, USA
*
Corresponding author: Nicholas B. Dadario; Email: nicholas.dadario@rutgers.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The Stop the Bleed course aims to improve bystander hemorrhage control skills and may be improved with point-of-care aids. We sought to create and examine a variety of cognitive aids to identify an optimal method to augment bystander hemorrhage control skills in an emergency scenario.

Methods:

Randomized trial of 346 college students. Effects of a visual or visual-audio aid on hemorrhage control skills were assessed through randomization into groups with and without prior training or familiarization with aids compared with controls. Tourniquet placement, wound packing skills, and participant comfortability were assessed during a simulated active shooter scenario.

Results:

A total of 325 (94%) participants were included in the final analyses. Participants who had attended training (odds ratio [OR], 12.67; P = 9.3 × 10−11), were provided a visual-audio aid (OR, 1.96; P = 0.04), and were primed on their aid (OR, 2.23; P = 0.01) were superior in tourniquet placement with less errors (P < 0.05). Using an aid did not improve wound packing scores compared with bleeding control training alone (P > 0.05). Aid use improved comfortability and likelihood to intervene emergency hemorrhage scenarios (P < 0.05).

Conclusions:

Using cognitive aids can improve bystander hemorrhage control skills with the strongest effects if they were previously trained and used an aid which combined visual and audio feedback that they were previously introduced to during the course training.

Keywords

active shooterhemorrhage controltourniquetwound packingstop the bleed
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e428
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the Society for Disaster Medicine and Public Health

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

FBI. Active shooter incidents in the United States in 2021. Published May 19, 2022. Accessed October 26, 2022. https://www.fbi.gov/filerepository/active-shooter-incidents-in-the-us-2021-052422.pdf Google Scholar
Bulger, EM, Gestring, ML, Jacobs, LM. Optimizing bleeding control training for the public: a national imperative. JAMA Surg. 2018;153(9):799. doi: 10.1001/jamasurg.2018.1100 CrossRefGoogle ScholarPubMed
Jacobs, LM, Wade, D, McSwain, NE, et al. Hartford Consensus: a call to action for THREAT, a medical disaster preparedness concept. J Am Coll Surg. 2014;218(3):467-475. doi: 10.1016/j.jamcollsurg.2013.12.009 CrossRefGoogle Scholar
Goolsby, C, Branting, A, Ausman, J, et al. Systematic review of live tissue versus simulation education for prehospital trauma providers. Mil Med. 2017;182(9):e1824-e1833. doi: 10.7205/MILMED-D-17-00026 CrossRefGoogle ScholarPubMed
Eastridge, BJ, Holcomb, JB, Shackelford, S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion. 2019;59(S2):1423-1428. doi: 10.1111/trf.15161 CrossRefGoogle ScholarPubMed
Dadario, NB, Felipes, RCS, Cooney, JV, et al. The impact of a mobile phone application for retention of bleeding control skills. J Surg Res. 2021;267:669-677. doi: 10.1016/j.jss.2021.06.021 CrossRefGoogle ScholarPubMed
Jafri, FN, Dadario, NB, Kumar, A, et al. The addition of high-technology into the Stop the Bleed Program among school personnel improves short-term skill application, not long-term retention. Simul Healthc. 2021;16(6):e159-e167. doi: 10.1097/SIH.0000000000000546 CrossRefGoogle Scholar
Goralnick, E, Chaudhary, MA, McCarty, JC, et al. Effectiveness of instructional interventions for hemorrhage control readiness for laypersons in the Public Access and Tourniquet Training Study (PATTS): a randomized clinical trial. JAMA Surg. 2018;153(9):791-799. doi: 10.1001/jamasurg.2018.1099 CrossRefGoogle ScholarPubMed
Humar, P, Goolsby, CA, Forsythe, RM, et al. Educating the public on hemorrhage control: methods and challenges of a public health initiative. Curr Surg Rep. 2020;8(5):1-7. doi: 10.1007/s40137-020-00252-8 CrossRefGoogle Scholar
Goolsby, C, Rojas, LE, Rodzik, RH, et al. High-school students can stop the bleed: a randomized, controlled educational trial. Acad Pediatr. 2021;21(2):321-328. doi: 10.1016/j.acap.2020.05.012 CrossRefGoogle ScholarPubMed
Weinman, S. Retention of tourniquet application skills following participation in a bleeding control course. J Emerg Nurs. 2020;46(2):154-162. doi: 10.1016/j.jen.2019.10.020 CrossRefGoogle Scholar
Chen, K-Y, Ko, Y-C, Hsieh, M-J, et al. Interventions to improve the quality of bystander cardiopulmonary resuscitation: a systematic review. PLoS One. 2019;14(2):e0211792. doi: 10.1371/journal.pone.0211792 CrossRefGoogle ScholarPubMed
Schulz, KF, Altman, DG, Moher, D, et al. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. Published 2010;340:c332. doi: 10.1136/bmj.c332 CrossRefGoogle ScholarPubMed
Gegel, B, Burgert, J, Cooley, B, et al. The effects of BleedArrest, Celox, and TraumaDex on hemorrhage control in a porcine model. J Surg Res. 2010;164(1):e125-e129 CrossRefGoogle ScholarPubMed
JEMS Staff. What the White House’s Stop the Bleed Campaign Means for EMS. Published April 5, 2016. Accessed October 26, 2022. https://www.jems.com/patient-care/trauma/what-the-white-house-s-stop-the-bleed-campaign-means-for-ems/ Google Scholar
Zasso, FB, Perelman, VS, Ye, XY, et al. Effects of prior exposure to a visual airway cognitive aid on decision-making in a simulated airway emergency: a randomised controlled study. Eur J Anaesthesiol. 2021;38(8):831-838. doi: 10.1097/EJA.0000000000001510 Google Scholar
Goolsby, C, Branting, A, Chen, E, et al. Just-in-time to save lives: a pilot study of layperson tourniquet application. Acad Emerg Med. 2015;22(9):1113-1117. doi: 10.1111/acem.12742 CrossRefGoogle ScholarPubMed
Arif, A, Santana Felipes, RC, Hoxhaj, M, et al. The impact of the addition of a virtual reality trainer on skill retention of tourniquet application for hemorrhage control among emergency medical technician students: a pilot study. Cureus. 2023;15(1):e34320. doi: 10.7759/cureus.34320 Google ScholarPubMed