The FAST VIP (First Aid for Severe Trauma “Virtual” in-Person) Educational Study

Author:

Goolsby Craig1,Schuler Keke2,Rodzik Raphaelle2,Charlton Nathan3,Lala Vidya4,Anderson Kevin4,Pellegrino Jeffrey5

Affiliation:

1. Uniformed Services University of the Health Sciences, Department of Military & Emergency Medicine, Bethesda, Maryland; Uniformed Services University of the Health Science, National Center for Disaster Medicine and Public Health Medicine, Bethesda, Maryland

2. Uniformed Services University of the Health Science, National Center for Disaster Medicine and Public Health Medicine, Bethesda, Maryland; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland

3. University of Virginia School of Medicine, Department of Emergency Medicine, Charlottesville, Virginia

4. Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, Maryland

5. University of Akron, Department of Disaster Sciences and Emergency Services, Akron, Ohio

Abstract

Introduction: Trauma is the leading cause of death for young Americans. Increased school violence, combined with an emphasis on early hemorrhage control, has boosted demand to treat injuries in schools. Meanwhile, coronavirus disease 2019 (COVID-19) has made educating the public about trauma more difficult. A federally funded high school education program in development, called First Aid for Severe Trauma™ (FAST™), will teach students to aid the severely injured. The program will be offered in instructor-led, web-based, and blended formats. We created a program to prepare high school teachers to become FAST instructors via “virtual” in-person (VIP) instruction. We used a webinar followed by VIP skills practice, using supplies shipped to participants’ homes. To our knowledge, no prior studies have evaluated this type of mass, widely distributed, VIP education. Methods: This study is a prospective, single-arm, educational cohort study. We enrolled a convenience sample of all high school teachers attending FAST sessions at the Health Occupations Students of America–Future Health Professionals International Leadership Conference. Half of the participants were randomized to complete the Stop the Bleed Education Assessment Tool (SBEAT) prior to the webinar, and the other completed it afterward; SBEAT is a validated tool to measure learning of bleeding competencies. We then performed 76 VIP video-training sessions from June–August 2020. The FAST instructors assessed each participant’s ability to apply a tourniquet and direct pressure individually, then provided interactive group skills training, and finally re-evaluated each participant’s performance post-training. Results: A total of 190 (96%) participants successfully applied a tourniquet after VIP training, compared to 136 (68%) prior to training (P < 0.001). Participants significantly improved their ability to apply direct pressure: 116 (56%) pre-assessment vs 204 (100%) post-assessment (P < 0.001). The mean score for the SBEAT increased significantly from pre-training to post-training: 2.09 with a standard deviation (SD) of 0.97 to 2.55 post-training with a SD of 0.72 (P < 0.001). Conclusion: This study suggests that a webinar combined with VIP training is effective for teaching tourniquet and direct-pressure application skills, as well as life-threatening bleeding knowledge. VIP education may be useful for creating resuscitative medicine instructors from distributed locations, and to reach learners who cannot attend classroom-based instruction.

Publisher

Western Journal of Emergency Medicine

Subject

General Medicine,Emergency Medicine

Reference25 articles.

1. Centers for Disease Control and Prevention. Injury prevention & control. 2017. Available at: https://www.cdc.gov/injury/wisqars/overview/key_data.html. Accessed April 29, 2019.

2. CNN. 10 years. 180 school shootings. 356 victims. 2019. Available at: https://www.cnn.com/interactive/2019/07/us/ten-years-of-school-shootings-trnd/. Accessed August 19, 2019.

3. Goolsby C, Rouse E, Rojas L, et al. Post-mortem evaluation of potentially survivable hemorrhagic death in a civilian population. J Am Coll Surg. 2018;227(5):502-6.

4. Scerbo MH, Holcomb JB, Taub E, et al. The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. J Trauma Acute Care Surg. 2017;83(6):1165-72.

5. Inaba K, Siboni S, Resnick S, et al. Tourniquet use for civilian extremity trauma. J Trauma Acute Care Surg. 2015;79(2):232-7;quiz 332-3.

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