Page 37 - JSOM Winter 2023

FIGURE 2 Times to reach a secured strap and touch the tightening system.

300 n=3 n=3 n=3
200 SOFTTW3 SOFTTW5
300 n=3 CAT7 TMT OMT X8T Tac RMT RST
200 150
150 140
140 CAT7 SOFTTW3 SOFTTW5 TMT OMT X8T Tac RMT RST 130
"Go" to "strap secured" (seconds) 110 "Go" to "strap secured" (seconds) 90
120
130
110
120
100
100
80
90
70
80
60
70
50
60
40
50
40
20
30
10
20 30
10 0
0
Good orientation Changed to Good orientation Bad orientation Good all strap/redirect Bad threading/clip Bad minor understanding Bad major understanding Bad opened hook-&-loop Bad pull technique Bad pull hook-&-loop Good strap tightness Bad strap tightness Good strap security Bad strap security
(A)
(B) 40
"Strap secured" to "touch tightening system" (seconds) 40 5 CAT7 SOFTTW3 SOFTTW5 TMT OMT X8T Tac RMT RST "Strap secured" to "touch tightening system" (seconds) 35 5 0 CAT7 SOFTTW3 SOFTTW5 TMT OMT X8T Tac RMT RST
30
35
25
30
25
20
15
20
15
10
10
0
Good orientation Changed to Good orientation Bad orientation Good all strap/redirect Bad threading/clip Bad minor understanding Bad major understanding Bad opened hook-&-loop Bad pull technique Bad pull hook-&-loop Good strap tightness Bad strap tightness Good strap security Bad strap security
(C)
(D)
A video orientation for the graphs can be accessed at https://vimeo.com/799927371. The x-axis • CAT7 (n=46) p=.107 (n=7 Bad strap security)
has application processes and process quality (good/bad) for processes that occur between pick- • SOFTTW5 (n=59) p<.0001 (n=1 Bad strap security because broke redirect)
ing the tourniquet up and achieving a secured tourniquet strap. Symbols for applications with • TMT (n=42) p=.008 (n=15 Bad strap security)
the good version of the indicated processes have open circles. Symbols for applications with a • Tac RMT p<.0001 (n=3 Bad strap security because never correctly rethreaded).
bad version have downward-pointing open triangles. Applications with an orientation process (C) Time differences from “Go” to “strap secured” versus “Go” to “touch tightening system” for
that started bad and changed to good have upward-pointing open triangles. The colors on the all applications according to placement orientation around the leg. Among the 461 applications
graphs are linked with the tourniquets as follows: CAT7 = gray, SOFTTW3 = red, SOFTTW5 = with good orientation, the TMT and Tac RMT were slower from “Go” to “touch tightening
orange, TMT = magenta, OMT = dark blue, X8T = dark green, Tac RMT = light green, RST = system” than each of the other six tourniquets (p<.050 TMT versus SOFTTW5, OMT, and X8T;
lavender. The “n=3” at the top of the Tac RMT columns indicates three applications with event p=.054 TMT versus CAT7; p=.109 TMT versus SOFTTW3; p=.063 TMT versus RST; p<.040
failures and the corresponding time assignments for the process of 300 seconds. Tac RMT versus each other tourniquet except TMT).
(A) Times from “Go” to “strap secured” for all applications according to placement orientation (D) Time differences from “Go” to “strap secured” versus “Go” to “touch tightening system” for
around the leg. Good was defined as the video-shown orientation 2-10 with the redirect buckle only applications with good orientation. P-values for time comparisons from “Go” to “touch
lateral and the tightening system located above the redirect (optimal strap pulling would be tightening” between each of the tourniquets are as follows:
downward). Among the 461 applications with good orientation, the TMT and Tac RMT were • Good all strap/redirect (meaning no bad strap or redirect processes), n=92, p<.030 Tac RMT
slower to secured than each of the other six tourniquets (p<.050 for each versus each of the versus each other tourniquet except TMT
other tourniquets except TMT versus SOFTTW3 p=.085). • Good strap tightness; n=229; p<.030 TMT versus CAT7, SOFTTW5, and OMT; p=.118 TMT
(B) Times from “Go” to “strap secured” for only applications with good orientation. P-values for versus SOFTTW3; p=.088 TMT versus RST
time comparisons between each of the tourniquets are as follows: • Good strap security; n=418; p<.050 TMT versus each other tourniquet except SOFTTW3 and
• Good all strap/redirect (meaning no bad strap or redirect processes), n=92, p<.008 Tac RMT Tac RMT; p=.111 TMT versus SOFTTW3; p<.020 Tac RMT versus CAT7, SOFTTW5, and
versus each other tourniquet except TMT X8T; p=.064 Tac RMT versus OMT.
• Good strap tightness; n=229; p<.010 TMT versus CAT7, SOFTTW5, and OMT; p=.094 TMT P-values for Good all strap/redirect time comparisons within a specific tourniquet are as follows:
versus SOFTTW3; p=.097 TMT versus RST • CAT7 (n=23) p=.0001 versus Bad pull hook-&-loop (n=3), p=.102 versus Bad strap security
• Good strap security; n=418; p<.030 TMT versus each other tourniquet except SOFTTW3 (n=7)
and Tac RMT; p=.079 TMT versus SOFTTW3; p<.009 Tac RMT versus CAT7, SOFTTW5, • SOFTTW3 (n=11) p<.001 versus Bad threading/clip (n=14) and Bad major understanding
OMT, and X8T. (n=10), p=.103 versus Bad minor understanding (n=9)
P-values for Good all strap/redirect time comparisons within a specific tourniquet are as follows: • SOFTTW5 (n=16) p<.0001 versus Bad threading/clip (n=9) and Bad major understanding
• CAT7 (n=23) p=.0001 versus Bad pull hook-&-loop (n=3), p=.117 versus Bad strap security (n=9)
(n=7) • TMT (n=5) p<.030 versus Bad threading/clip (n=30), Bad major understanding (n=27),
• SOFTTW3 (n=11) p<.0009 versus Bad threading/clip (n=14) and Bad major understanding Bad opened all hook-&-loop (n=3), and Bad strap security (n=15); p=.144 versus Bad pull
(n=10), p=.125 versus Bad minor understanding (n=9) technique (n=38); p=.130 versus Bad pull hook-&loop (n=19)
• SOFTTW5 (n=16) p<.0001 versus Bad threading/clip (n=9), Bad major understanding (n=9), • OMT (n=12) p<.030 versus Bad minor understanding (n=1) and Bad pull hook-&-loop (n=4)
and Bad strap security (n=1) • X8T (n=3) no p-values <.330
• TMT (n=5) p<.040 versus Bad threading/clip (n=30), Bad major understanding (n=27), Bad • Tac RMT (n=15) p<.0003 versus Bad threading/clip (n=16), Bad major understanding (n=16),
opened all hook-&-loop (n=3), and Bad strap security (n=15) Bad strap security (n=3)
• OMT (n=12) p=.0008 versus Bad minor understanding (n=1) • RST (n=7) p<.0001 versus Bad major understanding (n=4).
• X8T (n=3) no p-values <.560 No p-values <0.150 for Good strap tightness versus Bad strap tightness within a specific
• Tac RMT (n=15) p<.0003 versus Bad threading/clip (n=16), Bad major understanding (n=16), tourniquet.
Bad strap security (n=3) P-values for Good strap security versus Bad strap security within a specific tourniquet are as
• RST (n=7) p<.0001 versus Bad major understanding (n=4), p=.137 Bad threading/clip (n=21). follows:
No p-values <.150 for Good strap tightness versus Bad strap tightness within a specific • CAT7 (n=46) p=.091 (n=7 Bad strap security)
tourniquet. • TMT (n=42) p=.010 (n=15 Bad strap security)
P-values for Good strap security versus Bad strap security within a specific tourniquet are as • Tac RMT p<.0001 (n=3 Bad strap security because appliers never correctly rethreaded the
follows: redirect buckle.)
Tourniquet Processes Times | 35