BLEED TIME Simulation Study - Bleeding Limb, Effectiveness and Efficiency in Determining Time to Intervene on Mangled Extremity

Q: What was the study purpose regarding hemorrhagic extremity trauma simulation?

To determine whether simulation fidelity enhancements using a hemorrhagic pumping system (HPS) improve emergency providers’ performance in time-sensitive trauma scenarios.

Q: How were participants and simulation groups organized in the study?

A randomized case-control design enrolled 146 emergency care providers and assigned them to either standard moulage (Group A, no HPS) or active HPS (Group B), with stratification by profession/licensure before recruitment.

Q: What results did the study find about HPS and response timing?

Providers using HPS performed the first intervention significantly faster than those without HPS, while tourniquet-only application and scenario completion times were not affected. Improvements were especially seen in EMTs and providers without specific nursing or EMT licensure.

Sep 23, 2026

Uploaded by Mimi

Simulation-based medical education targets rare, high-acuity hemorrhagic extremity emergencies, yet evidence on whether added simulation realism improves provider performance is limited. A randomized case-control study at a rural Level I trauma center evaluated 146 emergency care providers managing simulated extremity trauma with standard moulage (no HPS) versus an active hemorrhagic pumping system (HPS). HPS use significantly reduced time to first intervention, particularly for EMTs and less-experienced providers; tourniquet-only and total scenario completion times showed no HPS effect.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Purpose

Patients and Methods

Results

Conclusion

Plain Language Summary

Advances in Medical Education and Practice downloaded from [https://www.dovepress.com/](https://www.dovepress.com/) For personal use only. Advances in Medical Education and Practice Open Access Full Text Article ORIGINAL RESEARCH BLEED TIME Simulation Study – Bleeding Limb, Effectiveness and Efficiency in Determining Time to Intervene on Mangled Extremity Timothy J Bikman 1 , 2 , William F Selde 1 , William B Belk 3 , Manoj Pathak4 , Craig E Palm 5 , Simon J Thompson 6 1Emergency Department, Billings Clinic, Billings, MT, USA; 2Simulation Experiential Learning Laboratory, Billings Clinic, Billings, MT, USA; 3Medical Simulation & Innovative Education, Air Methods Corporation, Greenwood Village, CO, USA; 4Department of Mathematics & Statistics, Murray State University, Murray, KY, USA; 5Trauma Services, Billings Clinic, Billings, MT, USA; 6Collaborative Science & Innovation, Billings Clinic, Billings, MT, USA Correspondence: Simon J Thompson, Collaborative Science & Innovation, Billings Clinic, Billings, MT, USA, Tel +1 503 267 7314, Fax +1 406 435 1586, Email [sthompson11@billingsclinic.org](sthompson11@billingsclinic.org) Purpose: Simulation-based education plays a pivotal role in preparing healthcare providers for rare, high-acuity emergencies such as hemorrhagic extremity trauma. Advances in simulation fidelity, including hemorrhagic pumping systems (HPS), may enhance realism, urgency, and clinical decision-making. However, evidence on how such enhancements affect provider performance remains limited. Patients and Methods: In this randomized case-control study at a rural Level I trauma center simulation learning laboratory, emergency care providers (n = 146) managed a simulated extremity trauma scenario using either standard moulage (Group A; No HPS) or an active HPS (Group B) . Participants were stratified by profession/licensure prior to recruitment. Within each professional stratum participants were randomized to ensure balanced representation, into the two groups and the timed endpoints included (i) First Intervention,(ii) Tourniquet-only Application, and (iii) Scenario Completion. Subgroup analyses were conducted by healthcare license (Emergency Medical Technician (EMT), Registered Nurse (RN), Others (neither EMT or RN licensure)) and years of licensure (<5 vs ≥5 years) . Results: Participants using the HPS performed the first intervention significantly faster (mean = 54.9s) than those with No HPS (mean = 71.9s; p=0.002) . EMTs and “Others” showed significant time improvements with HPS use, while RN performance did not differ. Tourniquet-only and Scenario Completion times were unaffected by HPS presence. Among RNs, those with <5 years of experience performed significantly faster in the first intervention than their more experienced peers (p=0.039); no other timing differences reached statistical significance based on licensure length. Conclusion: Enhanced realism within simulation-based education incorporating dynamic bleeding systems improves response time in initial trauma interventions, particularly among EMTs and less-experienced providers. While total scenario times and tourniquet application did not differ, early engagement appears positively influenced by simulation fidelity. Integrating high-fidelity elements like HPS into trauma training may strengthen learner urgency, decision-making, and improve real-world provider readiness. Plain Language Summary: This study explored how realistic bleeding simulations affect emergency care providers’ response times to a serious leg or arm injury. The goal was to see if adding a system that mimics real bleeding (called a hemorrhagic pumping system, or HPS) could improve how quickly and effectively providers react in a training scenario. Researchers tested 146 emergency workers at a rural trauma center. About half of them used a standard setup with no active bleeding (Group A), while the rest used a more realistic system that included simulated ble

FAQs

What was the study purpose regarding hemorrhagic extremity trauma simulation?

To determine whether simulation fidelity enhancements using a hemorrhagic pumping system (HPS) improve emergency providers’ performance in time-sensitive trauma scenarios.

How were participants and simulation groups organized in the study?

A randomized case-control design enrolled 146 emergency care providers and assigned them to either standard moulage (Group A, no HPS) or active HPS (Group B), with stratification by profession/licensure before recruitment.

What results did the study find about HPS and response timing?

Providers using HPS performed the first intervention significantly faster than those without HPS, while tourniquet-only application and scenario completion times were not affected. Improvements were especially seen in EMTs and providers without specific nursing or EMT licensure.

Sep 23, 2026

Uploaded by Mimi