FRIDAY, May 11, 2018 — Hemorrhage control training for laypersons is the most efficacious method for controlling hemorrhaging, according to a study published online May 9 in JAMA Surgery.
Eric Goralnick, M.D., from Brigham and Women’s Hospital in Boston, and colleagues examined the effectiveness of instructional point-of-care interventions and in-person training for hemorrhage control in a trial involving 465 laypersons. Correct tourniquet application was assessed for participants randomized into four groups: audio kits and flashcards (point-of-care interventions), a Bleeding Control Basic (B-Con) course, and control.
The researchers found that B-Con was superior to control for correct tourniquet application (88 versus 16 percent), while instructional flashcards and audio kit were not (19.6 and 23 percent, respectively). In the point-of-care arms, more than half of participants did not use the educational prompts as intended. Overall, 54.5 percent of the 303 participants assessed three to nine months after undergoing B-Con training could correctly apply a tourniquet. There was no further skill decay over this period in the adjusted model that treated time as either linear or quadratic. Age was the only demographic that was associated with correct application at retention; adults aged 18 to 35 years and aged 35 to 55 years were more likely to be efficacious than those aged >55 years (odds ratios, 2.39 and 1.77, respectively).
“In-person hemorrhage control training for laypersons is currently the most efficacious means of enabling bystanders to act to control hemorrhage,” the authors write.
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Posted: May 2018