A randomized controlled pilot trial of video-modelling versus telementoring for improved hemorrhage control wound packing

TeleMentored Ultrasound Supported Medical Interventions Research Group, Calgary, Alberta, Canada; Canadian Forces Medical Services, Canada; Regional Trauma Services, Calgary, Alberta, Canada; Department of Surgery, Calgary, Alberta, Canada; Department of Critical Care Medicine, Calgary, Alberta, Canada. Electronic address: Andrew.kirkpatrick@ahs.ca. TeleMentored Ultrasound Supported Medical Interventions Research Group, Calgary, Alberta, Canada. Canadian Forces Medical Services, Canada; 19 Wing and 442 Squadron Search Air Rescue, Canadian Forces Base Comox, Comox, British Columbia. Regional Trauma Services, Calgary, Alberta, Canada; Department of Surgery, Calgary, Alberta, Canada. Purdue University, West Lafayette, IN, USA; Indiana University School of Medicine, Indiana, USA.

American journal of surgery. 2022
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Abstract
INTRODUCTION Exsanguination is the most preventable cause of death. Paradigms such as STOP THE BLEED recognize increased responsibility among the less experienced with Wound Packing (WP) being a critical skill. As even trained providers may perform poorly, we compared Video-modelling (VM), a form of behavioural modelling involving video demonstration prior to intervention against remote telementoring (RTM) involving remote real-time expert-guidance. METHODS Search and Rescue (SAR-Techs), trained in WP were asked to pack a wound on a standardized simulator randomized to RMT, VM, or control. RESULTS 24 SAR-Techs (median age 37, median 16.5 years experience) participated. Controls were consistently faster than RTM (p = 0.005) and VM (p = 0.000), with no difference between RTM and VM. However, 50% (n = 4) Controls failed to pack properly, compared to 100% success in both VM and RTM, despite all SAR-Techs feeling the task was "easy". DISCUSSION Performance of a life-saving technique was improved through either VM or RTM, suggesting that both techniques are beneficial and complementary to each other. Further work should be extended to law enforcement/lay public to examine logistical challenges.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine