Welcome to AutoTQ Training! Thank you so much for being part of our training! Please fill out the following form before you begin training. Information about Trainee These questions are for the person who completed the training today. Trainee Name * First Name Last Name Trainee Email * Trainee gender * Male Female Trainee Date of Birth * MM DD YYYY If you are under 18, please obtain parental consent to complete this survey and the training. Have your parent type their name as acknowledgement below (please be honest!) Trainee level of education * Detail your highest level of education- elementary, middle, high school, bachelor's degree, masters degree, etc. Previous medical/trauma experience * Have you ever rendered first aid in real or simulated emergency settings? If yes, please specify. Trainee role / profession * What do you do for a living? i.e. student, first responder, healthcare provider, librarian, waste management professional Level of English Proficiency * Fluent Conversational Proficiency Elementary Proficiency Very limited / no English Trainee's first language * Level of Training * Check below for any first aid training you have. Tourniquet (i.e. Stop the Bleed course) CPR AED Certified paramedic / EMT None Other Level of Experience with AutoTQ * Today is my first time seeing and using AutoTQ. I've seen it before today, but have never used it. I've used AutoTQ before. Other (please explain) Pre-Knowledge Quiz Do your best to answer these questions! Don't worry if you don't know the answers yet, just answer honestly. What do tourniquets do? * A) It helps you breathe during an emergency B) It cools down the body when someone has a fever C) It stops dangerous bleeding from a hurt arm or leg D) It keeps your heart beating What is the most appropriate location to place a tourniquet on a bleeding limb? * A) Below the wound B) Directly over the wound C) As high as possible above the wound, on a joint D) As high as possible above the wound, on a forearm or upper leg How do you confirm that a tourniquet has been applied effectively? * The limb turns pale Bleeding stops The patient screams in pain The limb turns purple Which of the following is true about tourniquet use? * A) Tourniquets should never be used on children B) Tourniquets can safely stay on for 8+ hours C) A tourniquet should be loosened every 15 minutes D) Tourniquets are appropriate for life-threatening limb bleeding When is the use of a tourniquet appropriate? * A) For minor cuts or scrapes B) When there is life-threatening bleeding from a limb that cannot be controlled by direct pressure C) To treat internal abdominal bleeding D) When the patient is unconscious Acknowledge how comfortable you are with each statement: * If someone was bleeding badly, I would know what to do. Strongly Disagree Disagree Neutral Agree Strongly Agree I can put a tourniquet on someone by myself. Strongly Disagree Disagree Neutral Agree Strongly Agree I would be too nervous to try using a tourniquet if someone was bleeding. Strongly Disagree Disagree Neutral Agree Strongly Agree I can tell the difference between minor bleeding and life-threatening bleeding. Strongly Disagree Disagree Neutral Agree Strongly Agree Information about Buddy You can't train without a friend! Make sure you have a buddy to apply AutoTQ to. Name of buddy * You need a buddy to complete training! You will apply the tourniquet to them and check their pulse. Height of Buddy * Weight of Buddy * Buddy Date of Birth * MM DD YYYY Buddy gender * Male Female Buddy level of education * Detail your highest level of education- elementary, middle, high school, bachelor's degree, masters degree, etc. Buddy indications (if any) * Acknowledgement for Training Terms of Training * By submitting this form, you acknowledge and consent that the information provided herein will be used for the purposes of research and analysis in relation to tourniquet training effectiveness, application techniques, and related medical studies. We may utilize the data you provide in various analyses to improve understanding, enhance training protocols, develop new methodologies, and contribute to broader research in the field of emergency medical care and tourniquet usage. We may use this data in marketing for AutoTQ. All personal information will be kept confidential and will only be used for the stated research purposes. Your participation in this research is voluntary, and you may stop at any time. By proceeding with this submission, you are granting us permission to process and analyze your data in accordance with the aims of our research. We are committed to maintaining the highest standards of data protection and ethical research practices. If you have any questions or require further information regarding how your data will be used, please do not hesitate to contact us. By selecting "I accept", I have read and understand the above disclaimer and give my consent for the use of my data as described. I acknowledge that all data submitted in this form is true. I accept Today's Date MM DD YYYY Thank you! Please close this window and return to the training platform.
