A low‐cost, DIY tourniquet simulator with built‐in self‐assessment for prehospital providers in Guatemala city

Author:

Jhunjhunwala Rashi12ORCID,Monzon Jose3ORCID,Faria Isabella24ORCID,Escalona Gabriel56ORCID,Zinco Analia6ORCID,Ottolino Pablo6ORCID,Reyna Favio7ORCID,Raykar Nakul28ORCID,Asturias Sabrina9

Affiliation:

1. Beth Israel Deaconess Medical Center Boston Massachusetts USA

2. Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA

3. Rafael Landivar University Guatemala City Guatemala City Guatemala

4. Federal University of Minas Gerais Belo Horizonte Brazil

5. Faculty of Medicine Experimental Surgery and Simulation Center Pontificia Universidad Católica de Chile Santiago Chile

6. Hospital Sotero del Rio Puente Alto Chile

7. Francisco Marroquin University Guatemala City Guatemala

8. Brigham and Women's Hospital Boston Massachusetts USA

9. Hospital Roosevelt Ciudad de Guatemala Guatemala

Abstract

AbstractBackgroundHemorrhage is the leading cause of preventable death after trauma. In high‐income countries first responders are trained in hemorrhage control techniques but this is not the case for developing countries like Guatemala. We present a low‐cost training model for tourniquet application using a combination of virtual and physical components.MethodsThe training program includes a mobile application with didactic materials, videos and a gamified virtual reality environment for learning. Additionally, a physical training model of a bleeding lower extremity is developed allowing learners to practice tourniquet application using inexpensive and accessible materials. Validation of the simulator occurred through content and construct validation. Content validation involved subjective assessments by novices and experts, construct validation compared pre‐training novices with experts. Training validation compared pre and post training novices for improvement.ResultsOur findings indicate that users found the simulator useful, realistic, and satisfactory. We found significant differences in tourniquet application skills between pre‐training novices and experts. When comparing pre‐ and post‐training novices, we found a significantly lower bleeding control time between the groups.ConclusionThis study suggests that this training approach can enhance access to life‐saving skills for prehospital personnel. The inclusion of self‐assessment components enables self‐regulated learning and reduces the need for continuous instructor presence. Future improvements involve refining the tourniquet model, validating it with first‐responder end users, and expanding the training program to include other skills.

Funder

Intuitive Foundation

Publisher

Wiley

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