Effectiveness of Mobile Applications for Trauma Care in Combat Casualty Simulations Throughout the Continuum

The U.S. Military uses handwritten documentation throughout the continuum of combat casualty care to document from point-of-injury, during transport and at facilities that provide damage control resuscitation and surgery. Proven impractical due to lack of durability and legibility in arduous tactica...

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Bibliographic Details
Published in:	The Journal of surgical research Vol. 295; pp. 148 - 157
Main Authors:	Kenney, Connor L., Komarek, Tesserae A., July, Lindsey N., Schauer, Steven G., Burnett, Gregory M., VanFosson, Christopher A., Gurney, Jennifer M., Rizzo, Julie A., Sams, Valerie G.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-03-2024
Subjects:	BATDOK Combat casualty care Electronic health record Emergency Medical Services Humans Military Medicine Military Personnel Mobile Applications Resuscitation T6 health systems BATDOK Combat casualty care Electronic health record T6 health systems
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Summary:	The U.S. Military uses handwritten documentation throughout the continuum of combat casualty care to document from point-of-injury, during transport and at facilities that provide damage control resuscitation and surgery. Proven impractical due to lack of durability and legibility in arduous tactical environments, we hypothesized that mobile applications would increase accuracy and completeness of documentation in combat casualty simulations. We conducted simulations across this continuum utilizing 10 two-person teams consisting of a Medic and an Emergency or Critical Care Nurse. Participants were randomized to either the paper group or BATDOK and T6 Health Systems mobile application group. Simulations were completed in both the classroom and simulated field environments. All documentation was assessed for speed, completeness, and accuracy. Participant demographics averaged 10.8 ± 5.2 y of military service and 3.9 ± 0.6 h of training on both platforms. Classroom testing showed a significant increase in completeness (84.2 ± 8.1% versus 77.2 ± 6.9%; P = 0.02) and accuracy (77.6 ± 8.1% versus 68.9 ± 7.5%; P = 0.01) for mobile applications versus paper with no significant difference in overall time to completion (P = 0.19). Field testing again showed a significant increase in completeness (91.6 ± 5.8 % versus 70.0 ± 14.1%; P < 0.01) and accuracy (87.7 ± 7.6% versus 64.1 ± 14.4%; P < 0.01) with no significant difference in overall time to completion (P = 0.44). In deployed environments, mobile applications have the potential to improve casualty care documentation completeness and accuracy with minimal additional training. These efforts will assist in meeting an urgent operational need to enable our providers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0022-4804 1095-8673
DOI:	10.1016/j.jss.2023.10.028