Assessment of Groin Application of Junctional Tourniquets in a Manikin Model
Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet c...
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Veröffentlicht in: | Prehospital and disaster medicine 2016-08, Vol.31 (4), p.358-363 |
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creator | Kragh, John F. Lunati, Matthew P. Kharod, Chetan U. Cunningham, Cord W. Bailey, Jeffrey A. Stockinger, Zsolt T. Cap, Andrew P. Chen, Jacob Aden, James K. Cancio, Leopoldo C. |
description | Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet could perform differentially by blood loss, time to hemostasis, and user preference.
In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey's honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis. Kragh JF Jr , Lunati MP , Kharod CU , Cunningham CW , Bailey JA , Stockinger ZT , Cap AP , Chen J , Aden JK 3d , Cancio LC . Assessment of groin application of junctional tourniquets in a manikin model. Prehosp Disaster Med. 2016;31(4):358-363. |
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In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey's honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis. Kragh JF Jr , Lunati MP , Kharod CU , Cunningham CW , Bailey JA , Stockinger ZT , Cap AP , Chen J , Aden JK 3d , Cancio LC . Assessment of groin application of junctional tourniquets in a manikin model. Prehosp Disaster Med. 2016;31(4):358-363.</description><identifier>ISSN: 1049-023X</identifier><identifier>EISSN: 1945-1938</identifier><identifier>DOI: 10.1017/S1049023X16000443</identifier><identifier>PMID: 27230520</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Emergency Treatment - methods ; Emergency Treatment - standards ; Groin - injuries ; Health technology assessment ; Hemorrhage ; Hemorrhage - therapy ; Humans ; Injuries ; Manikins ; Medical equipment ; Military medicine ; Military Medicine - education ; Military Medicine - methods ; Military Medicine - standards ; Original Research ; Simulation Training - methods ; Simulation Training - standards ; Tourniquets ; United States ; Variance analysis</subject><ispartof>Prehospital and disaster medicine, 2016-08, Vol.31 (4), p.358-363</ispartof><rights>World Association for Disaster and Emergency Medicine 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-82210399e4ab4e36dfe2c9ba04cc7bc3b115fdfd6ce728c1a410bb7cd4f0f6c13</citedby><cites>FETCH-LOGICAL-c373t-82210399e4ab4e36dfe2c9ba04cc7bc3b115fdfd6ce728c1a410bb7cd4f0f6c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1049023X16000443/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,778,782,27907,27908,55611</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27230520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kragh, John F.</creatorcontrib><creatorcontrib>Lunati, Matthew P.</creatorcontrib><creatorcontrib>Kharod, Chetan U.</creatorcontrib><creatorcontrib>Cunningham, Cord W.</creatorcontrib><creatorcontrib>Bailey, Jeffrey A.</creatorcontrib><creatorcontrib>Stockinger, Zsolt T.</creatorcontrib><creatorcontrib>Cap, Andrew P.</creatorcontrib><creatorcontrib>Chen, Jacob</creatorcontrib><creatorcontrib>Aden, James K.</creatorcontrib><creatorcontrib>Cancio, Leopoldo C.</creatorcontrib><title>Assessment of Groin Application of Junctional Tourniquets in a Manikin Model</title><title>Prehospital and disaster medicine</title><addtitle>Prehosp. Disaster med</addtitle><description>Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet could perform differentially by blood loss, time to hemostasis, and user preference.
In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey's honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis. Kragh JF Jr , Lunati MP , Kharod CU , Cunningham CW , Bailey JA , Stockinger ZT , Cap AP , Chen J , Aden JK 3d , Cancio LC . Assessment of groin application of junctional tourniquets in a manikin model. Prehosp Disaster Med. 2016;31(4):358-363.</description><subject>Emergency Treatment - methods</subject><subject>Emergency Treatment - standards</subject><subject>Groin - injuries</subject><subject>Health technology assessment</subject><subject>Hemorrhage</subject><subject>Hemorrhage - therapy</subject><subject>Humans</subject><subject>Injuries</subject><subject>Manikins</subject><subject>Medical equipment</subject><subject>Military medicine</subject><subject>Military Medicine - education</subject><subject>Military Medicine - methods</subject><subject>Military Medicine - standards</subject><subject>Original Research</subject><subject>Simulation Training - methods</subject><subject>Simulation Training - standards</subject><subject>Tourniquets</subject><subject>United States</subject><subject>Variance analysis</subject><issn>1049-023X</issn><issn>1945-1938</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtOwzAQRS0EoqXwAWxQJDZsAuNXHsuqggJqxYIisYtsx0YuSVziZMHf49CCEIiF5SvPmTvji9AphksMOL16xMByIPQZJwDAGN1DY5wzHuOcZvtBh3I81EfoyPs1AMk5SQ7RiKSEAicwRoup99r7Wjdd5Ew0b51toulmU1klOuua4fG-b9SgRRWtXN829q3XnY8CKKKlaOxrUEtX6uoYHRhReX2yuyfo6eZ6NbuNFw_zu9l0ESua0i7OCMFA81wzIZmmSWk0UbkUwJRKpaISY25KUyZKpyRTWDAMUqaqZAZMojCdoIut76Z1YRffFbX1SleVaLTrfYEzSDmlWTgTdP4LXQ9fCNt9UoRzxnmg8JZSrfO-1abYtLYW7XuBoRiiLv5EHXrOds69rHX53fGVbQDozlTUsrXli_4x-1_bDzRMiBM</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Kragh, John F.</creator><creator>Lunati, Matthew P.</creator><creator>Kharod, Chetan U.</creator><creator>Cunningham, Cord W.</creator><creator>Bailey, Jeffrey A.</creator><creator>Stockinger, Zsolt T.</creator><creator>Cap, Andrew P.</creator><creator>Chen, Jacob</creator><creator>Aden, James K.</creator><creator>Cancio, Leopoldo C.</creator><general>Cambridge University Press</general><general>Jems Publishing Company, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201608</creationdate><title>Assessment of Groin Application of Junctional Tourniquets in a Manikin Model</title><author>Kragh, John F. ; Lunati, Matthew P. ; Kharod, Chetan U. ; Cunningham, Cord W. ; Bailey, Jeffrey A. ; Stockinger, Zsolt T. ; Cap, Andrew P. ; Chen, Jacob ; Aden, James K. ; Cancio, Leopoldo C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-82210399e4ab4e36dfe2c9ba04cc7bc3b115fdfd6ce728c1a410bb7cd4f0f6c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Emergency Treatment - methods</topic><topic>Emergency Treatment - standards</topic><topic>Groin - injuries</topic><topic>Health technology assessment</topic><topic>Hemorrhage</topic><topic>Hemorrhage - therapy</topic><topic>Humans</topic><topic>Injuries</topic><topic>Manikins</topic><topic>Medical equipment</topic><topic>Military medicine</topic><topic>Military Medicine - education</topic><topic>Military Medicine - methods</topic><topic>Military Medicine - standards</topic><topic>Original Research</topic><topic>Simulation Training - methods</topic><topic>Simulation Training - standards</topic><topic>Tourniquets</topic><topic>United States</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kragh, John F.</creatorcontrib><creatorcontrib>Lunati, Matthew P.</creatorcontrib><creatorcontrib>Kharod, Chetan U.</creatorcontrib><creatorcontrib>Cunningham, Cord W.</creatorcontrib><creatorcontrib>Bailey, Jeffrey A.</creatorcontrib><creatorcontrib>Stockinger, Zsolt T.</creatorcontrib><creatorcontrib>Cap, Andrew P.</creatorcontrib><creatorcontrib>Chen, Jacob</creatorcontrib><creatorcontrib>Aden, James K.</creatorcontrib><creatorcontrib>Cancio, Leopoldo C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Prehospital and disaster medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kragh, John F.</au><au>Lunati, Matthew P.</au><au>Kharod, Chetan U.</au><au>Cunningham, Cord W.</au><au>Bailey, Jeffrey A.</au><au>Stockinger, Zsolt T.</au><au>Cap, Andrew P.</au><au>Chen, Jacob</au><au>Aden, James K.</au><au>Cancio, Leopoldo C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Groin Application of Junctional Tourniquets in a Manikin Model</atitle><jtitle>Prehospital and disaster medicine</jtitle><addtitle>Prehosp. Disaster med</addtitle><date>2016-08</date><risdate>2016</risdate><volume>31</volume><issue>4</issue><spage>358</spage><epage>363</epage><pages>358-363</pages><issn>1049-023X</issn><eissn>1945-1938</eissn><abstract>Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet could perform differentially by blood loss, time to hemostasis, and user preference.
In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey's honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis. Kragh JF Jr , Lunati MP , Kharod CU , Cunningham CW , Bailey JA , Stockinger ZT , Cap AP , Chen J , Aden JK 3d , Cancio LC . Assessment of groin application of junctional tourniquets in a manikin model. Prehosp Disaster Med. 2016;31(4):358-363.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>27230520</pmid><doi>10.1017/S1049023X16000443</doi><tpages>6</tpages></addata></record> |
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subjects | Emergency Treatment - methods Emergency Treatment - standards Groin - injuries Health technology assessment Hemorrhage Hemorrhage - therapy Humans Injuries Manikins Medical equipment Military medicine Military Medicine - education Military Medicine - methods Military Medicine - standards Original Research Simulation Training - methods Simulation Training - standards Tourniquets United States Variance analysis |
title | Assessment of Groin Application of Junctional Tourniquets in a Manikin Model |
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