A randomized controlled pilot trial of video-modelling versus telementoring for improved hemorrhage control wound packing


      • Wound packing is a necessary but daunting skill for inexperienced responders to save lives.
      • Remote telementoring by an expert can improve the performance of a less experienced responder in simulation.
      • Pre-procedure viewing of a video presentation (video-modelling) can also improve the performance of a less experienced responder in simulation.
      • As first responders must often perform out-of-scope to save lives, medical informatics should be utilized to aid and reassure them in these duties.



      Exsanguination is the most preventable cause of death. Paradigms such as STOP THE BLEED recognize increased responsibility among the less experienced with Wound Packing (WP) being a critical skill. As even trained providers may perform poorly, we compared Video-modelling (VM), a form of behavioural modelling involving video demonstration prior to intervention against remote telementoring (RTM) involving remote real-time expert-guidance.


      Search and Rescue (SAR-Techs), trained in WP were asked to pack a wound on a standardized simulator randomized to RMT, VM, or control.


      24 SAR-Techs (median age 37, median 16.5 years experience) participated. Controls were consistently faster than RTM (p = 0.005) and VM (p = 0.000), with no difference between RTM and VM. However, 50% (n = 4) Controls failed to pack properly, compared to 100% success in both VM and RTM, despite all SAR-Techs feeling the task was “easy”.


      Performance of a life-saving technique was improved through either VM or RTM, suggesting that both techniques are beneficial and complementary to each other. Further work should be extended to law enforcement/lay public to examine logistical challenges.


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