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  • 1.
    Hedberg, Hans
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
    Hedberg, Pia
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Umeå University, Faculty of Medicine, Department of Nursing.
    Aléx, Jonas
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Sofia
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Haney, Michael
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
    Effects of an advanced first aid course or real-time video communication with ambulance personnel on layperson first response for building-site severe injury events: a simulation study2024In: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 24, no 1, article id 2Article in journal (Refereed)
    Abstract [en]

    Background: The risk of high-energy trauma injuries on construction sites is relatively high. A delayed response time could affect outcomes after severe injury. This study assessed if an advanced first aid course for first aid response for laypersons (employees or apprentices) in the construction industry or real-time video communication and support with ambulance personnel, or neither, together with access to an advanced medical kit, would have an effect on immediate layperson vital responses in a severe injury scenario.

    Method: This was a controlled simulation study. Employees or apprentices at a construction site were recruited and randomly allocated into a group with video support or not, and advanced first aid course or not, and where one group had both. The primary outcomes were correct behavior to recognize and manage an occluded airway and correct behavior to stop life-threatening bleeding from a lower extremity injury. Secondary outcomes included head-to-toe assessment performed, placement of a pelvic sling, and application of remote vital signs monitors.

    Results: Ninety participants were included in 10 groups of 3 for each of 4 exposures. One group was tested first as a baseline group, and then later after having done the training course. Live video support was effective in controlling bleeding. A first aid course given beforehand did not seem to be as effective on controlling bleeding. Video support and the first aid course previously given improved the ability of bystanders to manage the airway, the combination of the two being no better than each of the interventions taken in isolation. Course exposure and video support together were not superior to the course by itself or video by itself, except regarding placing the biosensors on the injured after video support. Secondary results showed an association between video support and completing a head-to-toe assessment. Both interventions were associated with applying a pelvic sling.

    Conclusion: These findings show that laypersons, here construction industry employees, can be supported to achieve good performance as first responders in a major injury scenario. Prior training, but especially live video support without prior training, improves layperson performance in this setting.

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  • 2.
    Hultin, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Hedberg, Hans
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Härgestam, Maria
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderström, Tor
    Umeå University, Faculty of Social Sciences, Department of Education.
    Thorstensson, Mirko
    Swedish Defense Research Agency (FOI), Linköping, Sweden.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Has five years of team training in non-technical skills improved trauma team performance in our University Hospital?2011In: Inspire... and be inspired: AMEE 2011 Abstract Book: 29-31 August 2011, Vienna, Austria, Scotland: Association for Medical Education in Europe , 2011, p. 447-447Conference paper (Refereed)
    Abstract [en]

    Background: For five years our emergency ward has trained non-technical skills using trauma scenarios in a simulator environment. Reflection-on-action was accomplished by 60 minutes video-facilitated structured debriefing. The aim of this study was to explore whether teams trained in non-technical skills are more efficient in the management of severely wounded patients.

    Summary of work: The standardized trauma patient scenario started with an ambulance crew being called

    to a location outside the hospital. Patient care was followed from the site of trauma, in the ambulance and

    in the emergency room. When the hand-over was finished, the condition was worsened. All ambulance crew and trauma team communication were recorded, synchronised in F-REX and key events time-logged. Nineteen teams with 144 participants were included in the study.

     

    Summary of results: 56% of the participants had trained non-technical skills. 78% of those with ontechnical

    skills training, and 62% of those without previous simulator based training, estimated themselves to have appropriate training for the task. The time from the induced worsened condition until the trauma team had assessed airways, breathing, circulation and disabilities were 74±39, 104±45, 172±85 and 223±194 s respectively. No significant effect on the medical performance on basis of previous training in non-technical skills could be detected. Further video analysis is required to more deeply understand the links between teamwork and medical performance.

     

    Conclusions: Trauma team training in CRM principles improves the self-confidence in trauma teams, but not the medical performance.

     

    Take-home messages: Improved non-technical skills might be difficult to translate into improvements in technical skills.

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