Page 49 - JSOM Fall 2020

FIGURE 1 Pressure results by inflation
time for wrap bladders.
The graph shows the pressure
magnitudes applied by pneumatic
bladders of AirWraps. The manikin
measurements were made intermittently.
The open squares represent an AirWrap
(4-in. width); the open circles represent
an AirWrap-XL (6-in. width).

FIGURE 2 Time-performance curve of an
investigator in converting a tourniquet to a
pressure dressing.
On average, the investigator took less time
to complete tests as experience was accrued.
Performances in the task of conversion became
faster in a power law of practice. The amount
of learning, as represented by the exponent, was
moderate.

FIGURE 3 Effect size of 3 minutes of manual
compression on test duration.
The graph shows the results of how large the
effect of 3 minutes taken to manually compress
the hemostatic gauze had on the test duration.
As the investigator accrued experience by the
test number in making the intervention of
conversion, those 3 minutes took up a greater
proportion of the test duration. Test duration
was a surrogate of task duration, and test
number was a surrogate of caregiver experience.
Coefficients and exponents had the same
magnitudes as in Figure 2 because Figure 3’s
data were simply the denominators of Figure 2’s
fractions: 3 min/(test duration).

as a pressure dressing was initiated so further simulation devel- paired tourniquet-conversion trials was practical and required
opment could be made. Notwithstanding the manikin, simula- no modification of manikin procedures. However, the mani-
tion workably sequenced the procedural steps and its evidence kin required the wrap to act as a tourniquet if the control of
showed promise of utility for further research. The manikin, bleeding was to result. The manikin unsatisfactorily tested the
a task trainer designed for tourniquet teaching, worked well present conversion type.
for testing tourniquet use. However, it was not designed to
gather data of conversion interventions. Unsurprisingly, test- That a wrap can act as a tourniquet is beyond the ken of some
ing conversion was awkward, because the manikin was unre- people, and the wrap is not so cleared by regulators. Such use
alistically too firm and also needed repeated push-button entry appears to be off-label. Our findings showed that with a spiral
of trial criteria in the midst of testing. Making each test as technique, we had a tourniquet effect when we wrapped tightly.

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