Conversion: Simulated Method of Exchanging Tourniquet Use for Pressure Dressing Use

Area of Science:

• Medical interventions
• Trauma care
• Emergency medicine

Background:

• Limited data exists for assessing guidelines on replacing field tourniquet use with pressure dressings.
• This study aimed to evaluate a stepwise procedure for converting tourniquets to pressure dressings.

Purpose of the Study:

• To test caregiver performance in controlling simulated bleeding by converting a tourniquet to a pressure dressing.
• To assess the effectiveness and efficiency of a novel tourniquet conversion method.

Main Methods:

• An experiment involved 15 trials of caregiver tourniquet-to-dressing conversions under simulated battlefield and emergency healthcare conditions.
• A HapMed Leg Tourniquet Trainer was used to simulate limb amputation and bleeding.
• Investigator-provided healthcare simulated emergency response.

Main Results:

• Mean test time decreased with experience, from 17 minutes initially to ≤7 minutes for the last six tests.
• Tourniquet use uniformly controlled bleeding (222 ± 18.0mmHg).
• Conversion to pressure dressing was less effective, with uncontrolled bleeding in one case and initial wrap success in 73% of attempts. Mean dressing pressure was 141 ± 17.6mmHg.

Conclusions:

• Caregiver performance in tourniquet conversion improved with experience.
• Tourniquet application was effective, but conversion to pressure dressings yielded inconsistent and poorer results.
• The simulated conversion highlighted potential issues with the manikin model and the procedure, suggesting a need for redesign and further development.