Training and Assessing Critical Airway, Breathing, and Hemorrhage Control Procedures for Trauma Care: Live Tissue Versus Synthetic Models

Introduction Optimal teaching and assessment methods and models for emergency airway, breathing, and hemorrhage interventions are not currently known. The University of Minnesota Combat Casualty Training consortium (UMN CCTC) was formed to explore the strengths and weaknesses of synthetic training models (STMs) versus live tissue (LT) models. In this study, we compare the effectiveness of best in class STMs versus an anesthetized caprine (goat) model for training and assessing seven procedures: junctional hemorrhage control, tourniquet (TQ) placement, chest seal, needle thoracostomy (NCD), nasopharyngeal airway (NPA), tube thoracostomy, and cricothyrotomy (Cric). Methods Army combat medics were randomized to one of four groups: 1) LT trained–LT tested (LT‐LT), 2) LT trained–STM tested (LT‐STM), 3) STM trained–LT tested (STM‐LT), and 4) STM trained–STM tested (STM‐STM). Participants trained in small groups for 3 to 4 hours and were evaluated individually. LT‐LT was the “control” to which other groups were compared, as this is the current military predeployment standard. The mean procedural scores (PSs) were compared using a pairwise t‐test with a Dunnett's correction. Logistic regression was used to compare critical fails (CFs) and skipped tasks. Results There were 559 subjects included. Junctional hemorrhage control revealed no difference in CFs, but LT‐tested subjects (LT‐LT and STM‐LT) skipped this task more than STM‐tested subjects (LT‐STM and STM‐STM; p