Abstract
Objective:to construct and validate a tool for the evaluation of responders in tactical casualty care simulations.Method:three rubrics for the application of a tourniquet, an emergency bandage and haemostatic agents recommended by the Hartford Consensus were developed and validated. Validity and reliability were studied. Validation was performed by 4 experts in the field and 36 nursing participants who were selected through convenience sampling. Three rubrics with 8 items were evaluated (except for the application of an emergency bandage, for which 7 items were evaluated). Each simulation was evaluated by 3 experts.Results:an excellent score was obtained for the correlation index for the 3 simulations and 2 levels that were evaluated (competent and expert). The mean score for the application of a tourniquet was 0.897, the mean score for the application of an emergency bandage was 0.982, and the mean score for the application of topical haemostats was 0.805.Conclusion:this instrument for the evaluation of nurses in tactical casualty care simulations is considered useful, valid and reliable for training in a prehospital setting for both professionals who lack experience in tactical casualty care and those who are considered to be experts.
Highlights
Prehospital care includes a wide range of health interventions, and the environment in which it is performed often complicates care because of the danger of staying on the scene; the assessment must be done quickly[1].The rapid assessment of dangerous environments is one of the challenges in emergency care during terrorist attacks
During combat, caring for the wounded is carried out following the Tactical Combat Casualty Care (TCCC) recommendations, in which special importance is given to the treatment of external bleeding, airway obstruction and tension pneumothorax
The recommendations of the Hartford Consensus are applied to civilian prehospital care in risky environments such as terrorist attacks, emphasizing the importance of the rapid control of external bleeding of victims by the first responder as well as the rapid transfer of the wounded to a safe area and evacuation by medical services to a centre used to receive definitive treatment
Summary
Prehospital care includes a wide range of health interventions, and the environment in which it is performed often complicates care because of the danger of staying on the scene (explosions, traffic accidents, extreme temperatures, etc.); the assessment must be done quickly[1].The rapid assessment of dangerous environments is one of the challenges in emergency care during terrorist attacks. Prehospital health care must adapt its procedures so that interventions in this environment are performed with maximum safety, both for the patient and for the responding personnel Based on this adequacy requirement, in 2013, recommendations of the Hartford Consensus[3] were published. During combat, caring for the wounded is carried out following the Tactical Combat Casualty Care (TCCC) recommendations, in which special importance is given to the treatment of external bleeding, airway obstruction and tension pneumothorax Supported by this experience, the recommendations of the Hartford Consensus are applied to civilian prehospital care in risky environments such as terrorist attacks, emphasizing the importance of the rapid control of external bleeding of victims by the first responder (security forces, health personnel) as well as the rapid transfer of the wounded to a safe area and evacuation by medical services to a centre used to receive definitive treatment. The recommendations of the Consensus establish 3 action zones as a function of environmental threat (hot, warm and cold zones), and tactical considerations are emphasized as determinants in prehospital care[4]
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