Page 94 - Journal of Special Operations Medicine - Summer 2017

Table 3 Relative Subjective Importance of Positively Rated General Features of High-Fidelity Simulators
Mean Rating Comparison Mean Significance
Rated Feature (Out of 5) (Out of 5) p-Value
Anatomically correct and realistic cricothyroidotomy site 4.68 4.05 .001
Realistic wounds (anatomy, feel, appearance) 4.68 4.05 .001
Bilateral chest needle decompression sites 4.60 4.05 .001
(midclavicular and anterior axillary line)
Realistic feedback to treatments and interaction 4.60 4.05 .001
Changeable vital signs 4.60 4.05 .001
Realistic palpable pulses at all sites (adjustable) 4.59 4.05 .001
Changeable wounds 4.59 4.05 .001
Packable wounds with pressure sensors 4.58 4.05 .001
Rise and fall of chest (spontaneous respirations) 4.56 4.05 .001
Rise and fall of chest with bag valve mask application 4.55 4.05 .001
Anatomically realistic chest tube insertion site 4.52 4.05 .001
Air moves through airway 4.51 4.05 .001
Tourniquet application works both proximal and 2 inches 4.51 4.05 .001
above wound
Realistic surface anatomy (visual and palpation) 4.50 4.05 .001
Uses organic medical diagnostic devices 4.45 4.05 .001
(BP, EtCO , SpO , ECG)
2 2
Lung sounds (changeable) 4.44 4.05 .001
Realistic weight distribution for casualty 4.43 4.05 .001
transport / manual carry
Adjustable tourniquet pressure threshold 4.43 4.05 .004
Durability (resist wear & tear, weather, 5ft drop) 4.40 4.05 .006
Water, mucus, blood in airway (suctionable) 4.39 4.05 .008
Realistic size blood volume reservoir (3L) 4.37 4.05 .02
IV / IO infusions that refill the blood reservoir 4.36 4.05 .031
Skin-over procedure sites bleed when cut 4.32 4.05 .018
Realistic feel and appearance of skin 4.32 4.05 .014
Chest tube insertion site feedback (air flutter or blood return) 4.29 4.05 .040
Waterproof / water resistant 4.28 4.05 .031

Subjective Results reported by 98 of 376 participants, was that live animal
Comments made on postsurvey items indicated that or animal tissue experiences would be replaced by mani-
personnel generally viewed HPSs as valuable training kin HPS. Furthermore, one in six (66 total) respondents
equipment. Free-text comments were overall positive, were cost conscious in their responses and more than
with 30 medics commenting that manikin HPS devices a dozen were concerned that HPS devices purchased
were useful for “practicing procedures.” For example, would fall short because of lack of “standardization” or
one medic wrote they were useful “especially [for prac- “readily available replacement kits.”
ticing] lifesaving measures such as cricothyroidotomy,
chest tubes, tourniquets (junctional especially), and even Discussion
intubation.” Other medics were satisfied that TCCC
curriculum was emphasized by current manikin HPS de- Overall, that participants in this study had high regard
vices, stating “focus should continue with key aspects for and achieved good value from manikin HPS devices,
based on current field treatments being rendered and as evidenced by their comments and high mean rat-
not ‘ideal’ treatments.” Although not specifically as- ings. Similar to what many previous studies have dem-
sessed by the survey, the most common overall concern, onstrated regarding these devices, our cohort reported

92 Journal of Special Operations Medicine Volume 17, Edition 2/Summer 2017