The publisher regrets . The publisher would like to apologise for any inconvenience caused. Practice makes perfect: The impact of Stop the Bleed training on hemorrhage control knowledge, wound packing, and tourniquet application in the workplaceInjuryVol. 50Issue 4PreviewTrauma remains the leading cause of death in individuals aged 1–44 in the United States [1]. Hemorrhage involving the extremities is the most frequent cause of preventable death from injury, which may occur as a result of intentional or unintentional trauma [2]. According the Federal Bureau of Investigation (FBI), 250 active shooter incidents occurred between 2000 and 2017 and resulted in the death of 799 individuals and injured 1418 others [3]. Shootings accounted for 394 cases of the 500 workplace homicides in 2016 [4]. Full-Text PDF

IntroductionThe national Stop the Bleed (STB) campaign was implemented in 2015 to provide hemorrhage control education to non-medical providers to reduce the number of deaths due to uncontrolled hemorrhage. Hands on training limits the availability of this program, and its importance is not known amongst lay providers. This study aimed to evaluate the efficacy of STB training for laypersons on knowledge and skill-based abilities in the workplace setting. We hypothesized such hands on and in-person training would improve performance.MethodsNon-medical potential first responders (PFR; N = 298) participated in STB training comprised of a lecture and hands-on component. PFRs completed a bleeding control knowledge-based pre-and post-assessment. Following the lecture, participants were divided into experimental and control groups during which hands-on practice was manipulated to determine the impact of guided practice on wound packing and tourniquet application. Wound packing and tourniquet application assessments were performed and scores compared between the experimental and control groups.ResultsPFRs scored higher on the bleeding control bleeding control knowledge-based post-test (M = 4.63, SD = 1.32) than on the pre-test (M = 3.21, SD = 1.14). Employees in the experimental group (M = 2.93, SD = .26) also scored significantly higher than the control group (M = 1.97, SD = .77) that attempted wound packing without any hands-on training. PFRs in the experimental group scored significantly higher (M = 7.41, SD = .91) than PFRs in the control group (M = 5.99, SD = 1.81) for tourniquet application.ConclusionKnowledge related to hemorrhage control increased following the STB course. Participants who engaged in hands-on practice for tourniquet and wound packing were more proficient than those who only saw the lecture. We confirm that in person, hands on training is key to the success of lay STB training.

Background: Safety restraint system (SRS) use is known to improve maternal and fetal outcomes in pregnant women. Factors associated with seatbelt use in females of child-bearing age are largely unstudied despite global public health endeavors to increase use. We sought to define its use and uncover risk factors for not using a restraint system in this vulnerable patient cohort. Materials and methods: A retrospective chart review of all female patients aged 15-35 y presenting from 2007 to 2017 was performed using our institutional level 1 trauma database. Age, pregnancy, insurance status (commercial or private, Medicaid plan, and uninsured), race, and Injury Severity Score (ISS) were examined in unmatched data. A matched cohort was created to evaluate the impact of pregnancy on SRS use based on ISS, age, race, and insurance status with blinding to belt use during matching (two nonpregnant to one pregnant). Differences in restraint use were then examined using Manne-Whitney U and Chi-square tests. Results: A total of 779 patients met inclusion criteria, of which 140 were pregnant. In unmatched data, there was no difference in belt use with regard to age, race, or insurance type. Overall belt use was 59%. Twenty-five percent of patients were uninsured, and 39% used a Medicaid plan. Pregnant patients were statistically more likely to wear belts (71% versus 57%, P = 0.003). In ISS-matched data, this difference was not upheld (63% pregnant belt use versus 58%, P = 0.615). Conclusions: Pregnancy did not induce improved safety behavior in our population. More study is needed to confirm our findings. Overall SRS use in our urban population is very poor, lags behind the national average, and requires additional public health attention. (C) 2019 Elsevier Inc. All rights reserved.

Pneumoscrotum is a rare complication that can result from various etiologies and can be essential in the diagnosis of those causative factors, especially life-threatening ones such as infection or trauma. We present here a case of a patient who presented in posttraumatic cardiac arrest and an extensive, grossly obvious, and rapidly expanding pneumoscrotum. Based on our patient's clinical presentation and a history of a high-speed mechanism with obvious torso trauma, a diagnosis of tension pneumothorax was quickly made resulting in immediate treatment. We review the existing literature and highlight the importance of pneumoscrotum in aiding with differential diagnosis. The presence of pneumoscrotum is often benign; however, in the right clinical setting, it can be an extremely important and useful clinical tool for the early identification and timely treatment of life-threatening diagnoses, such as tension pneumothorax.