The Bleeding Must Be Stopped! Management in the Situation of Hemorrhages-A Prospective Randomized Controlled Prospective Simulation Study.
Healthcare (Basel, Switzerland) · 2024-11-26 · Randomised trial
Abstract
INTRODUCTION: In a pre-hospital setting, uncontrolled hemorrhages in patients are undoubtedly a highly stressful situation for the rescuing medic, demanding prompt intervention. The effective stopping of a hemorrhage significantly reduces the risk of death for victims. The purpose of this study is to evaluate the students' chosen methods and the effectiveness of their actions during a simulated hemorrhage situation. In addition, the students' behavior and their cognitive overload classified using the NASA scale were also analyzed. METHODS: The study enrolled 101 medical students, who were randomized and assigned sequentially to a study group (n = 49) and a control group (n = 52). The research group participated in a training course. Both groups then proceeded to a simulated hemorrhage scenario in a patient in a pre-hospital setting. Finally, the students assessed their cognitive overload using the NASA scale. RESULTS: After the training, more students have achieved effective bleeding control (36/49, 73.5% vs. 22/52, 42.3%, p = 0.002). The prevalent method of bleeding control in both groups was using a tourniquet (97/101, 96%) with or without additional gauze and bandages. A significant improvement in the technique of the tourniquet application was observed-in the control group, 23/52 students (47.9%) applied it properly, while in the study group, it was 36/49 (73.5%). This resulted in a shorter time to achieve effective bleeding control and lower blood loss in the study group (p = 0.013 and p = 0.034, respectively). The median blood loss was 32 mL (IQR = 24, range 11-65 mL) in the study group compared to 53 mL (IQR = 26, range 10-117 mL) in the control group. CONCLUSIONS: The education program for young medics needs changes, including an increased emphasis on learning procedures and improving practical skills.
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