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The Untrained Public's Ability to Apply the Layperson Audiovisual Assist Tourniquet vs a Combat Application Tourniquet: A Randomized Controlled Trial

Department of Emergency Medicine, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, CA. Center for Disaster Medicine and Traumatology, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden. Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. National Center for Disaster Medicine and Public Health Medicine, Rockville, MD. The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc. Bethesda, MD. InnoVital Systems, Inc., Calverton, MD. Department of Surgery. University of Pennsylvania, Philadelphia, PA. Department of Computer and Information Science, Linköping University, Linköping, Sweden.

Journal of the American College of Surgeons. 2022
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PICO Summary

Population

Untrained members of the public (n= 147).

Intervention

Layperson Audiovisual Assist Tourniquet (LAVA TQ), (n= 73)

Comparison

Combat Application Tourniquet (CAT), (n= 74).

Outcome

Participants applied the novel LAVA TQ successfully 93% (n= 66 of 71) of the time compared to 22% (n= 16 of 73) success applying CAT [relative risk: 4.24 95% CI (2.74-6.57)]. Participants applied LAVA TQ faster (74.1 seconds) compared to CAT (126 seconds) and experienced a greater gain in comfort using LAVA TQ than CAT.
Abstract
BACKGROUND While the Stop the Bleed (STB) campaign's impact is encouraging, gaps remain. These gaps include rapid skill decay, a lack of easy-to-use tourniquets for the untrained public, and training barriers that prevent scalability. A team of academic and industry partners developed the Layperson Audiovisual Assist Tourniquet (LAVA TQ) - the first audiovisual-enabled tourniquet for public use. LAVA TQ addresses known tourniquet application challenges and is novel in its design and technology. METHODS This study is a prospective, randomized, superiority trial comparing the ability of the untrained public to apply LAVA TQ to a simulated leg versus their ability to apply a Combat Application Tourniquet (CAT). The study team enrolled participants in Boston, Maryland, and Sweden in 2022. The primary outcome was the proportion of successful applications of each tourniquet. Secondary outcomes included: mean time to application, placement position, reasons for failed application, and comfort with the devices. RESULTS Participants applied the novel LAVA TQ successfully 93% (n=66 of 71) of the time compared to 22% (n=16 of 73) success applying CAT [RR 4.24 95% CI (2.74-6.57)] (P < 0.001). Participants applied LAVA TQ faster (74.1s) compared to CAT (126s) (P <0.001) and experienced a greater gain in comfort using LAVA TQ than CAT. CONCLUSION The untrained public is four times more likely to apply LAVA TQ correctly than CAT. The public also applies LAVA TQ faster than CAT and has more favorable opinions about its usability. LAVA TQ's highly intuitive design and built-in audiovisual guidance solve known problems of layperson education and skill retention and could improve public bleeding control.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine