title: Assessment of users to control simulated junctional hemorrhage with the combat ready clamp (CRoC™).
abstract: The Combat Ready Clamp (CRoC™) was designed to control hemorrhage from the groin region, on the battlefield. The purpose of this experiment was to determine whether CRoC™ user performance varied by the surface the casualty laid on (flat-hard, flat-soft, and curved-soft) and how quickly the device could be applied. The commercial manikin selected to assess user performance was designed to train soldiers in CRoC™ use. The manikin simulated severe hemorrhage from an inguinal wound, controllable by correct use of the CRoC™. Each individual (n = 6) performed 3 iterations on each of the 3 surfaces (54 iterations total). The CRoC™ achieved hemorrhage control 100% of the time (54/54). Patient surface affected time to stop bleeding. The flat-soft surface (padded, 55 ± 9.7 seconds) was significantly different from the curved-soft surface (litter, 65 ± 16.5 seconds) and had the lowest overall total time (p = 0.007); time for the hard-flat surface was 58 ± 9.5 seconds. Users were trained to use the Combat Ready Clamp effectively, and the surface the casualty was lying on made some difference to user performance. All six persons trained had success in all nine of their iterations of CRoC™ use- a 100% rate. These findings indicate that training was effective and that training of other users is plausible, feasible, and practical within the scope of the present evidence.
authors: US Army Institute of Surgical Research San Antonio, TX.
authors: Elizabeth A
authors: EA
authors: Mann-Salinas
authors: John F
authors: JF
authors: Kragh
authors: Michael A
authors: MA
authors: Dubick
authors: David G
authors: DG
authors: Baer
authors: Lorne H
authors: LH
authors: Blackbourne
keywords: Tourniquets; hemorrhage; human patient simulation
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