INTRODUCTION:Educational escape games are increasingly used in health professions education, yet most studies focus on undergraduate learners and report primarily satisfaction or short-term knowledge outcomes. Evidence regarding theory-informed escape game design targeting human factors in continuing professional development (CPD) remains limited.The aims of this study were to evaluate the educational impact of a theory-informed, traumatology-focused escape game integrating technical and human factors competencies, using perceived self-efficacy as a Kirkpatrick Level 2 outcome. METHODS:We conducted a pre-post study across multiple CPD settings involving 81 emergency physicians, nurses, and trainees. The intervention was structured around the MARCHE algorithm and informed by experiential learning theory. Participants completed a seven-item self-efficacy questionnaire before and after the session. RESULTS:Significant improvements were observed across all technical and nontechnical domains (P < .001), with moderate to large effect sizes (r = 0.57-0.86). Experienced clinicians demonstrated gains primarily in nontechnical skills, whereas less experienced participants improved across all domains. DISCUSSION:A theory-guided escape game may represent a structured approach to reinforcing human factors in trauma CPD. Although limited to self-reported outcomes, these findings suggest that escape games can extend beyond engagement to support targeted nontechnical skills development in experienced clinicians.

No standardized cognitive aid (CA) exists to support the first medical responder during the initial organizational phase of a mass casualty incident (MCI). We aimed to develop such a tool through expert consensus using the Delphi method.A 2-round Delphi process was conducted with 20 expert prehospital physicians. Following a structured literature review, 46 items were submitted for evaluation using a 9-point Likert scale. Consensus criteria were defined a priori in accordance with HAS methodological guidelines. Retained items were ergonomically optimized using the Cognitive Aids in Medicine Assessment Tool (CMAT).All 20 experts participated in round 1 (100%); 18 completed round 2 (90%). After 2 rounds, 31 items were retained (acceptance rate 67%): 20 with strong agreement and 11 with relative agreement. The final CA is organized along the operational timeline of the first medical responder.This Delphi-based CA provides a structured, consensus-derived support tool for first medical responders during MCIs. Prospective studies in real or high-fidelity simulation settings are needed to evaluate its operational impact.

INTRODUCTION:Prehospital electrocardiogram teletransmission (E-ECG) enables early cardiac diagnosis and triage in the field. This study assessed its diagnostic and operational impact in a real-world Emergency Medical Service (EMS) in Marseille, France. METHODS:A retrospective, single-center observational study including adults ≥18 years who underwent E-ECG acquisition by Marseille first responders from January 1 through September 15, 2023 was conducted. Electronically transmitted prehospital ECGs were transmitted via Schiller devices to medical regulators. Patients with trauma, pediatric age, pregnancy, training cases, uninterpretable ECGs, or incomplete files were excluded. The main outcome was the proportion of acute ECG abnormalities (signs of ischemia, rhythm, or conduction disorders).Secondary outcomes included reinforcement requests, patient orientation, and transport mode. RESULTS:Among 425 included patients (Median age: 56 years [IQR 40-72]; 61% male), 21.9 % (n = 93) presented abnormal ECGs, including 2.1% with ST-elevation myocardial infarction (STEMI). Transmission results led to management changes in 11.5% of cases (n = 49): 8.2% required additional medical reinforcement and 3.3% underwent direct cardiology triage without medical reinforcement. Technical issues occurred in 15.8% of transmissions (n = 67). CONCLUSION:Prehospital ECG teletransmission allowed early detection of cardiac abnormalities and was associated with changes in patient management in a subset of cases. Its integration in emergency workflows could enhance triage, optimize cardiology routing, and strengthen coordination between field teams and regulation centers.

In 2010, we trained 10 general practitioner military residents in ultrasound in their first internship during 6-month posts.[1][1] Ten years later, we sought to assess the impact of the ultra-early clinical ultrasound training provided through university curricula on the current daily activity of

ABSTRACT Tranexamic acid is an inexpensive antifibrinolytic treatment that reduces morbidity and mortality in civilian and military trauma patients. It must be administered within 3 hours of the injury, and its efficacy is greater the earlier it is given. It is already used preventively in the civilian environment in a number of indications to reduce bleeding and bleeding-related mortality. We wondered about the potential benefits of preventive oral administration of tranexamic acid prior to an assault for military personnel with a potential risk of injury.

Broome, Jacob M. MD; Nordham, Kristen D. MD; Piehl, Mark MD; Tatum, Danielle PhD; Caputo, Sydney BS; Belding, Cameron MD; Taghavi, Sharven MD, MPH; Jackson-Weaver, Olan PhD; McGrew, Patrick MD; Smith, Alison MD, PhD; Nichols, Emily MD; Dransfield, Thomas NRP; Marino, Megan MD; Duchesne, Juan MD, MPH Author Information

Following the two earthquakes that occurred in Turkey on February 6, 2023 with magnitudes of 7.8 and 7.5, causing over 50,000 deaths and 100,000 injuries, France proposed to deploy, via the European Union Civil Protection Mechanism (EUCPM), the French Civil Protection Field Hospital (ESCRIM [Élément de Sécurité Civile Rapide d'Intervention Médicale]): the French World Health Organization (WHO)-classified Emergency Medical Team (EMT) Level 2 (EMT2).After the acceptance from Turkey on February 8, a disaster assessment team (DAT) was sent on February 10, 2023. It was decided, with local health authorities (LHA), to set up the field hospital in Gölbaşi, Adiyaman Province where the State Hospital was closed due to a structural risk.Arriving in Gölbaşi on February 13 at 2:00am in -12°C (10°F) temperatures, the detachment had no choice but to begin setting up the base of operation (BoO). At dawn, the cold was so intense that one doctor suffered from frostbite. Once the BoO was installed, the team set up the hospital tents. From 11:00am, the sun melted the snow and the ground became very muddy. The objective being to open the hospital as soon as possible, installation of the hospital continued, and it opened on February 14 at 12:00pm/noon, less than 36 hours after on-site arrival.This article describes the mechanics of setting up an EMT-2 in a cold climate, the many problems encountered, and the solutions imagined and proposed.

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Cazes, Nicolas MD; Balaz, Pierre-Alexis MD; Renard, Aurélien MD; Boutillier du Retail, Cédric MD Author Information

We read with great interest the article by Blenkinsop et al [1][1] and thank them for this focus on the value of using ultrasounds in overseas missions. The authors described a clinical case in which the on-site doctor diagnosed deep vein thrombosis by telemedicine while geographically isolated

In Brief This work should not lead us to lower the level of management of penetrating trauma patients, but rather to better understand the mechanisms that led to these results, which will allow us later to determine which patients need aggressive prehospital ALS management.