Mass casualty incidents and B-Con training

Authors

  • Jose A. Robaina, MD
  • Scott B. Crawford, MD
  • Diane Huerta, MPH
  • Danielle Austin, BA
  • Radosveta M. Wells, MD
  • Stormy M. Monks, PhD

DOI:

https://doi.org/10.5055/jem.2018.0388

Keywords:

B-Con, tourniquet, mass causality, training, healthcare provider

Abstract

Objective: The purpose of this study was to determine if providing mass casualty training, utilizing the Bleeding Control for the Injured (B-Con) course would allow participants to feel more confident to provide bystander aid to wounded victims in a mass casualty incident (MCI).

Design: Quasi-experimental pre-post intervention study.

Setting: Participants were healthcare providers attending a trauma research conference hosted by a medical university.

Interventions: Participants were given a group lecture in each of the three B-Con skill areas. These include: bleeding control with a tourniquet, bleeding control with gauze, and airway control with a jaw thrust. Participants were then divided into three groups and practiced each skill with instruction from B-Con certified trainers.

Main outcomes measures: The primary outcome was scores from pre- to post-intervention in the categories of self-efficacy, perceived benefit, perceived susceptibility, perceived barriers, and perceived severity related to involvement in an MCI.

Results: The study included 67 participants, all identifying as medical providers. Means in the categories of self-efficacy, perceived benefit, perceived susceptibility, perceived barriers, and perceived severity significantly increased from pre-intervention to postintervention among the paired variables.

Conclusions: This study demonstrates the effectiveness of B-Con training in improving the confidence of participants. By increasing the number of persons who are trained for an MCI, there will be an increased probability that triage and immediate care will be rendered when needed. Future research needs to be completed evaluating the effect of training on a layperson study sample.

Author Biographies

Jose A. Robaina, MD

Orthopaedic Residency, University of Arizona College of Medicine, Phoenix, Arizona

Scott B. Crawford, MD

Assistant Professor, Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

Diane Huerta, MPH

Research Assistant, Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.

 

Danielle Austin, BA

Research Associate, Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

Radosveta M. Wells, MD

Assistant Professor, Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

Stormy M. Monks, PhD

Assistant Professor, Texas Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

References

Federal Bureau of Investigation: Quick Look: 220 Active Shooter Incidents in the United States between 2000-2016. Washington, DC: US Department of Justice, Federal Bureau of Investigations, 2017.

Federal Bureau of Investigation: A Study of Active Shooter Incidents in the United States between 2000 and 2013. Washington, DC: US Department of Justice, Federal Bureau of Investigations, 2013.

Federal Bureau of Investigation: 2000 to 2016 Active Shooter Incidents. Washington, DC: US Department of Justice, Federal Bureau of Investigations, 2017.

CNN Library: Deadliest mass shootings in modern US history fast facts. CNN. April 1, 2018. Available at https://www.cnn.com/2013/09/16/us/20-deadliest-mass-shootings-in-u-s-history-fastfacts/index.html. Accessed May 2, 2018.

Caterson EJ, Carty MJ, Weaver MJ, et al.: Boston bombings: A surgical view of lessons learned from combat casualty care and the applicability to Boston’s terrorist attack. J Craniofac Surg. 2013; 24(4): 1061-1067.

Jacobs LM, McSwain NE Jr, Rotondo MF, et al.: Improving survival from active shooter events: The Hartford Consensus. J Trauma Acute Care Surg. 2013; 74(6): 1399-1400.

Jacobs LM, Sinclair J, Rotondo M, et al.: The Hartford Consensus II. Bull Am Coll Surg. 2013; 98(6): 14-16.

Jacobs LM Jr: The Hartford Consensus III: Implementation of bleeding control—If you see something do something. Bull Am Coll Surg. 2015; 100(7): 20.

Jacobs LM: The Hartford Consensus IV: A call for increased national resilience. Bull Am Coll Surg. 2016; 101(3): 17-24.

Jacobs L, Burns KJ: The Hartford Consensus to improve survivability in mass casualty events: Process to policy. Am J Disaster Med. 2014; 9(1): 67-71.

Goolsby C, Branting A, Chen E, et al.: Just in time to save lives: A pilot study of layperson tourniquet application. Acad Emerg Med. 2015; 22(9): 1113-1117.

Goolsby C, Chen E, Branting A, et al.: Analysis of layperson tourniquet application using a novel color-coded device. Disaster Med Public Health Prep. 2016; 10(2): 274-280.

Jacobs LM, Burns KJ: The Hartford Consensus: Survey of the public and healthcare professionals on active shooter events in hospitals. J Am Coll Surg. 2017; 225(3): 435-442.

NAEMT: NAEMT introduces new course to help communities respond to active shooter and mass casualty incidents. Available at http://www.naemt.org/Files/media/NAEMT%20B-Con%20Course%20press%20release%209-5-14.pdf. Accessed January 10, 2018.

Jacobs LM, Wade D, McSwain NE, et al.: Hartford Consensus: A call to action for THREAT, a medical disaster preparedness concept. J Am Coll Surg. 2014; 218(3): 467-475.

Lee CW, McLeod SL, Van Aarsen K, et al.: First responder accuracy using SALT during mass-casualty incident simulation. Prehosp Disaster Med. 2016; 31(2): 150-154.

Schenk E, Wijetunge G, Mann NC, et al.: Epidemiology of mass casualty incidents in the United States. Prehosp Emerg Care. 2014; 18(3): 408-416.

Vincent DS, Burgess L, Berg BW, et al.: Teaching mass casualty triage skills using iterative multimanikin simulations. Prehosp Emerg Care. 2009; 13(2): 241-246.

Andreatta P, Klotz JJ, Madsen JM, et al.: Outcomes from two forms of training for first-responder competency in cholinergic crisis management. Mil Med. 2015; 180(4): 468-474.

Hayden J: Introduction to Health Behavior Theory. 2nd ed. Sudbury, MA: Jones and Bartlett, 2009.

Glanz K, Rimer BK, Viswanath K (eds.): Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: John Wiley & Sons, 2008.

Published

11/01/2018

How to Cite

Robaina, MD, J. A., S. B. Crawford, MD, D. Huerta, MPH, D. Austin, BA, R. M. Wells, MD, and S. M. Monks, PhD. “Mass Casualty Incidents and B-Con Training”. Journal of Emergency Management, vol. 16, no. 6, Nov. 2018, pp. 397-04, doi:10.5055/jem.2018.0388.