Exploring Combat Tourniquet Application Errors and Duration Among Skilled and Novice Medical Trainees

Area of Science:

• Combat Medicine
• Trauma Care
• Medical Training

Background:

• Massive extremity hemorrhage is a leading cause of preventable battlefield death.
• Tourniquets are critical interventions for controlling such bleeding.
• Assessing tourniquet application proficiency among military medical personnel is essential.

Purpose of the Study:

• To analyze tourniquet application performance among combat medics (68W) and combat lifesavers (CLSs).
• To determine consistency in tourniquet application skills among trainees.
• To investigate the association between participant demographics and tourniquet application performance.

Main Methods:

• Participants applied Combat Application Tourniquets (CATs) to patient simulators with simulated amputated legs.
• Video coding assessed tourniquet application subtasks and identified potential errors.
• Time to application and duration were recorded to correlate with performance and variability.

Main Results:

• Tourniquet application performance was not predicted by participant role, time in role, or self-reported skill/confidence.
• Demographic variables did not predict successful CAT application, defined by windlass rotations.
• Participant role and self-reported skill/experience predicted tourniquet application duration.

Conclusions:

• Significant variability exists in CAT application methodology and performance among CLSs and combat medics.
• This variability is largely unpredictable by demographics, suggesting inconsistencies in training.
• Reassessment of CAT application training for consistency and validation is recommended.