Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T12:25:00.292Z Has data issue: false hasContentIssue false

Red Alert: It Is Time to Strengthen the Medical Knowledge of Noncompressible Torso Hemorrhage Among Health-Care Workers

Published online by Cambridge University Press:  18 October 2021

Hua-yu Zhang
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Yong Guo
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Hao Tang
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Xiao-ying Huang
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Dong Liu
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Yu-zhuo Han
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Peng Chen
Affiliation:
Department of Neurosurgery, Emergency Medical Center of Chongqing, Chongqing, China
Yang Li
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Lian-yang Zhang*
Affiliation:
Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
*
Corresponding author: Lian-Yang Zhang, Email: [email protected].

Abstract

Objective:

Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.

Methods:

A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.

Results:

A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).

Conclusions:

Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Holcomb, JB, McMullin, NR, Pearse, L, et al. Causes of death in U.S. special operations forces in the global war on terrorism. Ann Surg. 2007;245(6):986-991.Google ScholarPubMed
Kelly, JF, Ritenour, AE, McLaughlin, DF, et al. Injury severity and causes of death from operation Iraqi freedom and operation enduring freedom: 2003-2004 versus 2006. J Trauma. 2008;64(2):S21-S27.Google ScholarPubMed
Alarhayem, AQ, Myers, JG, Dent, D, et al. Time is the enemy: mortality in trauma patients with hemorrhage from torso injury occurs long before the “golden hour”. Am J Surg. 2016;212(6):1101-1105.Google ScholarPubMed
Howard, JT, Kotwal, RS, Turner, CA, et al. Use of combat casualty care data to assess the US military trauma system during the Afghanistan and Iraq conflicts, 2001-2017. JAMA Surg. 2019;154(7):600-608.Google ScholarPubMed
Eastridge, BJ, Mabry, RL, Seguin, P, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6):S431-S437.CrossRefGoogle ScholarPubMed
Morrison, JJ, Stannard, A, Rasmussen, TE, et al. Injury pattern and mortality of noncompressible torso hemorrhage in UK combat casualties. J Trauma Acute Care Surg. 2013;75(2):S263-S268.Google ScholarPubMed
Beck, B, Smith, K, Mercier, E, et al. Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths. PLoS One. 2019;14(6):e0217158.CrossRefGoogle ScholarPubMed
Teixeira, PGR, Inaba, K, Hadjizacharia, P, et al. Preventable or potentially preventable mortality at a mature trauma center. J Trauma. 2007;63(6):1338-1347.Google ScholarPubMed
Kleber, C, Giesecke, MT, Tsokos, M, et al. Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education. World J Surg. 2013;37(5):1154-1161.Google ScholarPubMed
Bège, T, Pauly, V, Orleans, V, et al. Epidemiology of trauma in France: mortality and risk factors based on a national medico-administrative database. Anaesth Crit Care Pain Med. 2019;38(5):461-468.Google ScholarPubMed
Kisat, MT, Morrison, JJ, Hashmi, ZG, et al. Epidemiology and outcomes of non-compressible torso hemorrhage (NCTH) in civilian trauma. J Surg Res. 2013;184(1):414-421.CrossRefGoogle Scholar
Newgard, CD, Nelson, MJ, Kampp, M, et al. Out-of-hospital decision making and factors influencing the regional distribution of injured patients in a trauma system. J Trauma. 2011;70(6):1345-1353.Google Scholar
Aboutanos, MB, Rodas, EB, Aboutanos, SZ, et al. Trauma education and care in the jungle of Ecuador, where there is no advanced trauma life support. J Trauma. 2007;62(3):714-719.Google ScholarPubMed
Beekley, AC, Sebesta, JA, Blackbourne, LH, et al. Prehospital tourniquet use in operation Iraqi freedom: effect on hemorrhage control and outcomes. J Trauma. 2008;64(2):S28-S37.Google ScholarPubMed
Gurney, JM, Stern, CA, Kotwal, RS, et al. Tactical combat casualty care training, knowledge, and utilization in the US army. Mil Med. 2020;185(S1):500-507.CrossRefGoogle ScholarPubMed
Goodwin, T, Moore, KN, Pasley, JD, et al. From the battlefield to main street: tourniquet acceptance, use, and translation from the military to civilian settings. J Trauma Acute Care Surg. 2019;87(1):S35-S39.Google ScholarPubMed
Butler, FK, Holcomb, JB, Shackelford, S, et al. Advanced resuscitative care in tactical combat casualty care: TCCC guidelines change 18-01:14 October 2018. J Spec Oper Med. 2018;18(4):37-55.Google ScholarPubMed
Zhou, JL, Li, YH, Wang, QK, et al. Status of road safety and injury burden: China. J Orthop Trauma. 2014;28(Suppl 1):S41-S42.Google ScholarPubMed
Valente, TW, Paredes, P, Poppe, PR. Matching the message to the process: the relative ordering of knowledge, attitudes, and practices in behavior change research. Hum Commun Res. 1998;24(3):366-385.Google Scholar
Hu, BB, Liu, YY, Zhang, XX, et al. Understanding regional talent attraction and its influencing factors in China: from the perspective of spatiotemporal pattern evolution. PLoS One. 2020;doi: 10.1371/journal.pone.0234856.Google ScholarPubMed
Eggleston, K, Lu, MS, Li, CD, et al. Comparing public and private hospitals in China: evidence from Guangdong. BMC Health Serv Res. 2010;10:76-86.CrossRefGoogle ScholarPubMed
Blackbourne, LH, Mabry, R, Sebesta, J, et al. Joseph Lister, noncompressible arterial hemorrhage, and the next generation of “tourniquets”? US Army Med Dep J. 2008;56-59.Google Scholar
Mabry, RL, Holcomb, JB, Baker, AM, et al. United States army rangers in Somalia: an analysis of combat casualties on an urban battlefield. J Trauma. 2000;49(3):515-528.CrossRefGoogle Scholar
Gordon, W, Talbot, M, Fleming, M, et al. High bilateral amputations and dismounted complex blast injury (DCBI). Mil Med. 2018;183(S2):118-122.Google Scholar
Kheirabadi, BS, Terrazas, IB, Hanson, MA, et al. In vivo assessment of the combat ready clamp to control junctional hemorrhage in swine. J Trauma Acute Care Surg. 2013;74(5):1260-1265.CrossRefGoogle ScholarPubMed
Brännström, A, Rocksén, D, Hartman, J, et al. Abdominal aortic and junctional tourniquet release after 240 minutes is survivable and associated with small intestine and liver ischemia after porcine class II hemorrhage. J Trauma Acute Care Surg. 2018;85(4):717-724.CrossRefGoogle ScholarPubMed
Kheirabadi, B, Terrazas, IB, Miranda, N, et al. Long-term consequences of abdominal aortic and junctional tourniquet for hemorrhage control. J Surg Res. 2018;231:99-108.CrossRefGoogle ScholarPubMed
Klotz, JK, Leo, M, Andersen, BL, et al. First case report of SAM(r) Junctional tourniquet use in Afghanistan to control inguinal hemorrhage on the battlefield. J Spec Oper Med. 2014;14(2):1-5.CrossRefGoogle ScholarPubMed
Croushorn, J. Abdominal aortic and junctional tourniquet controls hemorrhage from a gunshot wound of the left groin. J Spec Oper Med. 2014;14(2):6-8.CrossRefGoogle ScholarPubMed
Morrison, JJ. Noncompressible torso hemorrhage. Crit Care Clin. 2017;33(1):37-54.CrossRefGoogle ScholarPubMed
Shirazi, M, Lonka, K, Parikh, SV, et al. A tailored educational intervention improves doctor’s performance in managing depression: a randomized controlled trial. J Eval Clin Pract. 2013;19(1):16-24.Google ScholarPubMed
Samuel, A, Cervero, RM, Durning, SJ, et al. Effect of continuing professional development on health professionals’ performance and patient outcomes: a scoping review of knowledge syntheses. Acad Med. 2020;doi: 10.1097/ACM.0000000000003899.Google Scholar
Adhikari, B, Khatiwada, AP, Shrestha, R, et al. Assessing pharmacy practitioners’ perceptions of continuing pharmacy education and professional development at an oncology service hospital in Nepal: a pilot study. Adv Med Educ Pract. 2020;11:911-919.Google ScholarPubMed
Khamis, S, Abdi, AM, Basgut, B. Preparing lifelong learners for delivering pharmaceutical care in an ever-changing world: a study of pharmacy students. BMC Med Educ. 2020;20(1):502-514.CrossRefGoogle Scholar
Brzezinski, M, Kukreja, J, Mitchell, JD. Time-efficient, goal-directed, and evidence-based teaching in the ICU. Curr Opin Anaesthesiol. 2019;32(2):136-143.Google ScholarPubMed
Supplementary material: File

Zhang et al. supplementary material

Zhang et al. supplementary material

Download Zhang et al. supplementary material(File)
File 26 KB