A High Fidelity Simulation Study in Assessing Proficiency of Emergency Medical Professionals in Prehospital Management of Traumatic Hemorrhagic Shock

Introduction: According to the World Health Organization, traffic accidents are a leading cause of fatalities, particularly among young adults aged 5–29, with hemorrhage being the primary cause of death in traumatic incidents. The average time from the onset of shock to death is approximately 2 h, illustrating the need for rapid assessment, timely intervention, and prompt transport to a trauma centre. EEmergency Medical Professional (EMP), are typically the first on the scene to attend to patients with traumatic injuries and play a crucial role in determining patient outcomes; they must be on their toes in the management of these emergencies. Methods: Our aim was to assess the proficiency of Emergency Medical Professionals (EMPs) in handling hemorrhagic shock in a simulated scenario. The simulation study comprised 300 Emergency Medical Professionals, both new and experienced across India, and was conducted over a period of 6 months. The participants were scored on a checklist with a maximum of 10 points. High-fidelity manikins were used, and participants were divided into 30 groups for 45-min sessions, which included pre-briefing, simulation, and debriefing. Results: The results demonstrate strong proficiency among EMPs in initial trauma assessment skills but reveal critical gaps in recognizing life-threatening conditions like exsanguinating hemorrhage and “Load and Go” situations. Despite exhibiting technical proficiency in the International Trauma Life Support ITLS primary survey, participants struggled to translate assessments into life-saving interventions. There was a significant failure to recognize exsanguinating hemorrhage (46.7%), declare “load-and-go” situations (36.3%), and administer tranexamic acid (0%). In the Indian context of prolonged transport times, this lack of situational awareness is concerning. Bridging this gap requires targeted, simulation-based experiential learning to help EMPs evolve from simply completing checklists to executing rapid, critical prioritization in real-world emergencies. Conclusion: The study highlights a notable proficiency gap among EMPs in key shock management skills, emphasizing the importance of continuous training to enhance patient outcomes and elevate care standards in trauma care.