Background Perfused cadavers are viable training models for operating room surgical skills, increasing fidelity of vascular anatomy, dissection, and tissue handling. In addition, perfused cadavers may have benefits in military medical training environments with a focus on hemorrhage control and vascular access. Objectives We created a large-scale training exercise with perfused cadavers in three different environments and aim to share the curricular design and feedback from the exercise. Methods We conducted a 4-day simulation training exercise with 13 perfused cadavers in 3 different environments: hospital environment, the austere echelons of care environment, and a controlled-settings tent for hemorrhage control and needle decompression training. Through an anonymous online survey and an after-action review (AAR), we elicited feedback on advantages, disadvantages, costs, and comparison to models of porcine and fresh cadavers for procedures and existing courses. Results A total of 324 participants were trained with 13 perfused cadavers for over 4 days from a variety of specialties and on different procedures and surgical skills. Based on 130 respondents to the survey and the AAR, perfused cadavers were rated to have realistic arterial bleeding and bleeding control training. In addition, perfused cadavers provided increased realism and fidelity for surgical skills. There were disadvantages of logistical requirements, cleanup, costs, and mobility. Conclusion Perfused cadavers can be implemented effectively for hemorrhage control training, surgical and procedure skills, and even exercises in austere environments, but require significant logistical and planning considerations. The training value is maximized with a progressive curriculum from hemorrhage control iterations to more invasive surgical procedures, such as thoracotomy and exploratory laparotomy.

中文翻译：

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经验教训：三种不同课程环境中的大规模尸体灌注训练

背景 灌注尸体是手术室手术技能、提高血管解剖、解剖和组织处理保真度的可行培训模型。此外，灌注尸体可能在军事医疗训练环境中受益，重点是出血控制和血管通路。目标 我们在三种不同环境中使用灌注尸体进行了大规模培训练习，旨在分享课程设计和练习反馈。方法 我们对 13 具灌注尸体在 3 个不同的环境中进行了为期 4 天的模拟训练：医院环境、严峻的护理环境以及用于控制出血和针刺减压训练的受控设置帐篷。通过匿名在线调查和事后审查（AAR），我们收集了有关优点、缺点、成本的反馈，以及与猪和新鲜尸体模型的程序和现有课程的比较。结果 共有 324 名参与者使用 13 具灌注尸体接受了为期 4 天多的培训，这些培训来自不同的专业，并接受了不同的手术和手术技能。根据调查和 AAR 的 130 名受访者，灌注尸体被评为具有真实的动脉出血和出血控制训练。此外，灌注尸体为手术技能提供了更高的真实性和保真度。在后勤要求、清理、成本和流动性方面存在缺点。结论 灌注尸体可以有效地用于出血控制训练、手术和操作技能，甚至在严峻环境下的练习，但需要大量的后勤和规划考虑。通过从出血控制迭代到更具侵入性的外科手术（例如开胸术和剖腹探查术）的渐进式课程，可以最大限度地提高培训价值。