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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.
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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

Information

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

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