Self-rated readiness for performance of needle decompression in combat lifesaver training

Abstract

Background: The Combat Lifesaver course taught to nonmedical personnel includes instruction on performing needle thoracostomy to decompress tension pneumothorax, the second leading cause of preventable combat death. Although the Tactical Combat Casualty Care curriculum is pushed to the lowest level of battlefield first responders, the instruction of this advanced procedure is routinely limited to a verbal block of instruction with a standardized presentation. Objective: The purpose of this study was to assess the confidence of nonmedical personnel in their preparation to perform a needle thoracostomy before Combat Lifesaver training, after verbal instruction on the procedure, manikin training, and practice on a human cadaver. Methods: Confidence was assessed by Likert scale surveys, as well as free response remarks collected before and after training. Results: Self-rated preparedness scores improved significantly with each level of training. Maximal improvements followed cadaver training, from a mean score of 2.31/5 before instruction to 4.75/5 following cadaver training (matched pairs t test: p < 0.005). Conclusions: Cadaver training provided the largest single educational confidence boost for needle decompression skills, and is an effective method of enhancing confidence in needle decompression. © Association of Military Surgeons of the U.S. All rights reserved.