EMS-TruShoC - A Prospective Trial of Low-Dose, High Frequency, On-Site Training to Improve Trauma Field Care in Austere Settings

Abstract

Effective training is critical to survival after major trauma . We tested the effectiveness of a simplified bundle of hemorrhagic shock care ("EMS-TruShoC") delivered via a novel educational methodology ("H.E.E.T.") intended to pragmatically improve prehospital trauma morbidity and mortality. We assessed outcomes in three highly relevant areas: (i) clinical at the patient-level; (ii) implementation, and (iii) educational. The overall design was a Type 2 hybrid implementation-effectiveness study (equal focus on clinical and implementation outcomes). We conducted a quasi-experimental trial to introduce a novel intervention (EMS-TruShoC) which was implemented via a novel educational methodology (H.E.E.T.). We enrolled 198 EMS providers and 770 critical patients. Patients in shock (due to penetrating injuries) who received the TruShoC intervention (delivered by BLS providers) had clinically improved (but statistically non-significant) clinical outcomes compared to control-site patients. We implemented the H.E.E.T. training program with high implementation fidelity (76% mean effectiveness, per RE-AIM). Knowledge and skills acquisition and retention (up to 12-months post-intervention) of TruShoC was superior in our intervention effort.

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Document Details

Document Type
Technical Report
Publication Date
Aug 11, 2021
Accession Number
AD1151889

Entities

People

  • Adit A. Ginde
  • Joseph K Maddry
  • Nee-Kofi Mould-Millman
  • Shaheem De Vries
  • Steven G Schauer
  • Vikhyat S Bebarta

Organizations

  • 59th Medical Wing
  • University of Colorado Boulder

Tags

DTIC Thesaurus Topics

  • Air Force
  • Blood
  • Brain Injuries
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System
  • Combat Casualty Care
  • Data Analysis
  • Electronic Mail
  • Health Services
  • Heart Rate
  • Hemorrhage
  • Hemorrhagic Shock
  • Injury Prevention
  • Institutional Review Board
  • Medical Personnel
  • Military Medicine
  • Penetrating Wounds
  • Thoracic Injuries
  • Urban Areas
  • Vital Signs
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

  • Neurotrauma and Rehabilitation Medicine.
  • Psychological Intervention/Treatment for Stress, Anxiety, PTSD, and Related Emotional and Cognitive Health Symptoms.