Division of Trauma, Critical and Acute Care, Department of Surgery, Weill Cornell Medicine, New York, New York.
Division of Trauma, Critical and Acute Care, Department of Surgery, Weill Cornell Medicine, New York, New York.
J Surg Res. 2019 Dec;244:516-520. doi: 10.1016/j.jss.2019.06.041. Epub 2019 Jul 20.
As active shootings and mass casualty incidents have become more prevalent, courses designed to teach basic hemorrhage control to laypersons have proliferated. Participants currently undergo Stop the Bleed (StB) training currently use a synthetic limb mannequin. In a prior survey of 88 participants, there was overwhelming sentiment that the mannequin was limited by its inability to demonstrate cessation of bleeding when hemorrhage control techniques were applied. We hypothesized that simulated bleeding that can be controlled by StB techniques would improve the mannequin and increase confidence of trainees in achieving bleeding control.
The mannequin was redesigned to be a self-contained model mimicking bleeding, with fluid flowing from a reservoir into a latex tubing with a laceration mimicking an arterial wound. Fluid was pumped by a rubber bulb attached to the tubing and held in the instructor's hand. Twenty StB trainers conducted beta testing of the perfused mannequin. Forty participants underwent training with both old and new models and completed posttraining surveys.
Beta-testers reported positive feedback regarding both realism of the perfused mannequin and participants' ability to obtain bleeding control using StB techniques. Participants who trialed the mannequin reported increased awareness of the rate of blood flow out of a wound, which in turn increased their sense of urgency to achieve hemostasis.
In an effort to address shortcomings noted by participants in the current StB mannequin, we developed a novel perfused bleeding mannequin, which responds appropriately to various hemorrhage cessation techniques and is both high fidelity and low cost.
随着活跃枪击和大规模伤亡事件的增多,为非专业人士设计的基本出血控制课程已经普及。目前,参与者正在接受“停止出血”(Stop the Bleed,StB)培训,他们使用的是合成肢体模型人。在之前对 88 名参与者的调查中,绝大多数人认为该模型人存在局限性,因为当应用出血控制技术时,它无法演示出血是否停止。我们假设可以通过 StB 技术控制的模拟出血将改进模型人,并提高学员实现出血控制的信心。
该模型人经过重新设计,成为一个可自我模拟出血的独立模型,其液体从储液器流入带有模拟动脉伤口的乳胶管。液体由连接到管上的橡胶球泵入,并由指导员手持。20 名 StB 培训师对灌注模型人进行了测试。40 名参与者接受了新旧模型的培训,并完成了培训后的调查。
测试者报告说,灌注模型人的逼真性以及参与者使用 StB 技术获得出血控制的能力都得到了积极的反馈。试用该模型的参与者报告说,他们对伤口出血速度的认识有所提高,这反过来又增加了他们实现止血的紧迫感。
为了解决当前 StB 模型人存在的缺点,我们开发了一种新型的灌注出血模型人,它对各种止血技术有适当的反应,具有高保真度和低成本。