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    Development of a post-mortem human specimen flow model for advanced bleeding control training

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    Author
    Vrancken, Suzanne M.
    Borger van der Burg, Boudewijn L.S.
    Stark, Pieter W.
    van Waes, Oscar J.F.
    DuBose, Joseph J.
    Benjamin, Elizabeth R.
    Lieber, André
    Verhofstad, Michael H.J.
    Kleinrensink, Gert Jan
    Hoencamp, Rigo
    Date
    2022-01-01
    Journal
    Injury
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.injury.2022.07.051
    Abstract
    Introduction: Prompt and effective hemorrhage control is paramount to improve survival in patients with catastrophic bleeding. In the ever-expanding field of bleeding control techniques, there is a need for a realistic training model to practice these life-saving skills. This study aimed to create a realistic perfused post-mortem human specimen (PMHS) flow model that is suitable for training various bleeding control techniques. Materials and Methods: This laboratory study was conducted in the SkillsLab & Simulation Center of Erasmus MC, University Medical Center Rotterdam, the Netherlands. One fresh frozen and five AnubiFiX® embalmed PMHS were used for the development of the model. Subsequent improvements in the exact preparation and design of the flow model were made based on model performance and challenges that occurred during this study and are described. Results: Circulating arteriovenous flow with hypertonic saline was established throughout the entire body via inflow and outflow cannulas in the carotid artery and jugular vein of embalmed PMHS. We observed full circulation and major hemorrhage could be mimicked. Effective bleeding control was achieved by placing a resuscitative endovascular balloon occlusion of the aorta (REBOA) catheter in the model. Regional perfusion significantly reduced the development of tissue edema. Conclusion: Our perfused PMHS model with circulating arterial and venous flow appears to be a feasible method for the training of multiple bleeding control techniques. Regional arteriovenous flow successfully reduces tissue edema and increases the durability of the model. Further research should focus on reducing edema and enhancing the durability of the model. © 2022 The Author(s)
    Keyword
    Bleeding control
    Flow model
    Human cadaver
    Perfusion
    Training
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/19569
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.injury.2022.07.051
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