Page 96 - Journal of Special Operations Medicine - Summer 2017

Table 6 Features of High-Fidelity Simulators Scored as Not Significantly Different in Importance from a Calculated Mean
Comparison Variable
Preprogrammed Sounds
Including Screams
Nontethered Operation and Talking Intubation Use Finger Pulse Oximetry
Ease-of-operation Weight of 130-150 pounds Nasopharyngeal airway use End-tidal carbon dioxide
Modular peripherals Temperature of skin is Supraglottic airway use Blood pressure assessment
(including modular changeable
extremities)
Ease of changing limbs Reaction to painful stimuli Junctional tourniquet Wound closure
including grimace application to the axilla
Nonproprietary connections Urine catheterization in and Junctional tourniquet Chest compression response
out fluid feedback application to the aorta
Intramuscular injection sites Electrocardiogram Junctional tourniquet Amputation injury extremity
monitoring application to the neck
Humidified air misting Distal cyanosis Chest feedback to needle Pelvic fracture with crepitus
decompression
Comprehensiveness of Capillary refill Chest tube application Abdominal wounds
function for first responder bilaterally (mesenteric bleeds)
to Role 2 simulations
Realistic joints Recording function for after Peripheral intravenous sites Abdominal wounds
action review purposes on arms
Adjustable pupils Battery exchangeable during Peripheral intravenous sites Extremity fractures
operations on legs
Pupillary response to light Remote tablet computer Peripheral intravenous sites Airway obstruction by
based operation of jugular veins foreign body
Facial cyanosis Remote operation by tablet Extremity intraosseous site Airway obstruction from
computer altered anatomy
Eyes open and close Manikin evokes realistic Multiple extremity Chest wound with air
emotion intraosseous and venous sites exchange

Additional features likely targeted at those working in of additive type I error require repeat investigation of
emergency rooms and who administer anesthesia, like this kind to draw firm conclusions about individual sig-
defibrillation and electrocardiogram responses, as well nificant findings. Caution would be warranted in using
as nasogastric tube response and bowel sounds, are of- these results alone to include or exclude features in a
ten included by industry but are excessive to what our purpose-generated manikin HPS device.
field medical users want and need. These features may
represent an area of cost savings for both manufactur- Conclusion
ers and military medical consumers for models of HPS
devices used in field medical training. Likewise, those This study showed that medics from USASOC and US-
surveyed reported low interest in having multiple mod- SOCOM have confidence in manikin HPS devices, and
els of different sexes and races, many stating that these their ratings of manikin HPS features generally align
additional models represent a superfluous cost to the with the goals of TCCC training. Some device features
goal of casualty care training. are significantly more valued by field medical provid-
ers than others. Specifically, users value those features
The limitations of this study are many, including that the related to improving lifesaving procedural skills, while
survey elements used have not been previously validated, not needing expensive audio or automation features.
and overall results may not be entirely generalizable to Evaluations such as those included in this study may
any but our specialized study population. Moreover, guide future development or procurement of manikin
the simple 5-point Likert scale used was never designed HPS devices.
for the sensitivity we have applied in this paper and,
thus, there may be minor practical significance for even Disclosure
highly statistically significant results. Additionally, the
large number of variables investigated and possibility The author has nothing to disclose.

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