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Stop the Bleed: The Effect of Hemorrhage Control Education on Laypersons’ Willingness to Respond During a Traumatic Medical Emergency

Published online by Cambridge University Press:  19 February 2018

Elliot M. Ross ,
Theodore T. Redman ,
Julian G. Mapp ,
Derek J. Brown ,
Kaori Tanaka ,
Craig W. Cooley ,
Chetan U. Kharod  and
David A. Wampler
Elliot M. Ross*
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TexasUSA Prehospital Research and Innovation in Military and Expeditionary Environments (PRIME2) Research Group, San Antonio, TexasUSA
Theodore T. Redman
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TexasUSA Prehospital Research and Innovation in Military and Expeditionary Environments (PRIME2) Research Group, San Antonio, TexasUSA
Julian G. Mapp
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TexasUSA Prehospital Research and Innovation in Military and Expeditionary Environments (PRIME2) Research Group, San Antonio, TexasUSA
Derek J. Brown
Affiliation:
San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TexasUSA US Army Institute of Surgical Research, JBSA Fort Sam Houston, TexasUSA
Kaori Tanaka
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA
Craig W. Cooley
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA University of Texas Health Science Center San Antonio, Department of Emergency Medicine, San Antonio, TexasUSA
Chetan U. Kharod
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TexasUSA Prehospital Research and Innovation in Military and Expeditionary Environments (PRIME2) Research Group, San Antonio, TexasUSA
David A. Wampler
Affiliation:
University of Texas Health Science Center San Antonio, Office of the Medical Director, San Antonio, TexasUSA
*
Correspondence: Elliot M. Ross, MD, MPH University of Texas Health Science Center at San Antonio 4201 Medical Drive, Unit 370 San Antonio, Texas 78229 USA E-mail: s5eross@yahoo.com
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Abstract

Background

The “Stop the Bleed” campaign advocates for non-medical personnel to be trained in basic hemorrhage control. However, it is not clear what type of education or the duration of instruction needed to meet that requirement. The objective of this study was to determine the impact of a brief hemorrhage control educational curriculum on the willingness of laypersons to respond during a traumatic emergency.

Methods

This “Stop the Bleed” education initiative was conducted by the University of Texas Health San Antonio Office of the Medical Director (San Antonio, Texas USA) between September 2016 and March 2017. Individuals with formal medical certification were excluded from this analysis. Trainers used a pre-event questionnaire to assess participants knowledge and attitudes about tourniquets and responding to traumatic emergencies. Each training course included an individual evaluation of tourniquet placement, 20 minutes of didactic instruction on hemorrhage control techniques, and hands-on instruction with tourniquet application on both adult and child mannequins. The primary outcome in this study was the willingness to use a tourniquet in response to a traumatic medical emergency.

Results

Of 236 participants, 218 met the eligibility criteria. When initially asked if they would use a tourniquet in real life, 64.2% (140/218) responded “Yes.” Following training, 95.6% (194/203) of participants responded that they would use a tourniquet in real life. When participants were asked about their comfort level with using a tourniquet in real life, there was a statistically significant improvement between their initial response and their response post training (2.5 versus 4.0, based on 5-point Likert scale; P<.001).

Conclusion

In this hemorrhage control education study, it was found that a short educational intervention can improve laypersons’ self-efficacy and reported willingness to use a tourniquet in an emergency. Identified barriers to act should be addressed when designing future hemorrhage control public health education campaigns. Community education should continue to be a priority of the “Stop the Bleed” campaign.

RossEM, RedmanTT, MappJG, BrownDJ, TanakaK, CooleyCW, KharodCU, WamplerDA. Stop the Bleed: The Effect of Hemorrhage Control Education on Laypersons’ Willingness to Respond During a Traumatic Medical Emergency. Prehosp Disaster Med. 2018;33(2):127–132.

Keywords

hemorrhage control trainingstop the bleedtourniquet training
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 2 , April 2018 , pp. 127 - 132
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest/disclaimer: The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Army, the Department of the Air Force, the Department of the Navy, Department of Defense, or the United States Government. “I am a military service member. This work was prepared as part of my official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the US Government.’ Title 17, USC, §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties.” The authors have no conflicts of interest to declare.

References

1. Homeland Security. http://www.dhs.gov/stopthebleed. Accessed February 5, 2016.Google Scholar
2. Blair, JP, Schweit, KW. A study of active shooter incidents, 2000-2013. Texas State University and Federal Bureau of Investigation, US Department of Justice. Washington, DC USA: 2014.Google Scholar
3. Jacobs, LM, McSwain, NE Jr., Rotondo, MF, et al; Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events. Improving survival from active shooter events: the Hartford Consensus. J Trauma Acute Care Surg. 2013;74(6):1399-1400.Google Scholar
4. Ashour, A, Cameron, P, Bernard, S, Fitzgerald, M, Smith, K, Walker, T. Could bystander first‐aid prevent trauma deaths at the scene of injury? Emerg Med Australas. 2007;19(2):163-168.Google Scholar
5. Centers for Disease Control and Prevention. Welcome to WISQARS. http://www.cdc.gov/injury/wisqars/index.html. Accessed February 5, 2016.Google Scholar
6. Swor, R, Khan, I, Domeier, R, Honeycutt, L, Chu, K, Compton, S. CPR training and CPR performance: do CPR‐trained bystanders perform CPR? Acad Emerg Med. 2006;13(6):596-601.Google ScholarPubMed
7. Locke, CJ, Berg, RA, Sanders, AB, et al. Bystander cardiopulmonary resuscitation: concerns about mouth-to-mouth contact. Arch Intern Med. 1995;155(9):938-943.CrossRefGoogle ScholarPubMed
8. Shotland, RL, Heinold, WD. Bystander response to arterial bleeding: helping skills, the decision-making process, and differentiating the helping response. J Pers Soc Psychol. 1985;49(2):347.CrossRefGoogle ScholarPubMed
9. Vaillancourt, C, Lui, A, De Maio, VJ, Wells, GA, Stiell, IG. Socioeconomic status influences bystander CPR and survival rates for out-of-hospital cardiac arrest victims. Resuscitation. 2008;79(3):417-423.Google Scholar
10. Root, ED, Gonzales, L, Persse, DE, Hinchey, PR, McNally, B, Sasson, C. A tale of two cities: the role of neighborhood socioeconomic status in spatial clustering of bystander CPR in Austin and Houston. Resuscitation. 2013;84(6):752-759.Google Scholar
11. Chiang, WC, Ko, PCI, Chang, AM, et al. Bystander-initiated CPR in an Asian metropolitan: does the socioeconomic status matter? Resuscitation. 2014;85(1):53-58.Google Scholar
12. Hamasu, S, Morimoto, T, Kuramoto, N, et al. Effects of BLS training on factors associated with attitude toward CPR in college students. Resuscitation. 2009;80(3):359-364.Google Scholar
13. Shibata, K, Taniguchi, T, Yoshida, M, Yamamoto, K. Obstacles to bystander cardiopulmonary resuscitation in Japan. Resuscitation. 2000;44(3):187-193.Google Scholar
14. Goolsby, C, Branting, A, Chen, E, Mack, E, Olsen, C. Just‐in‐time to save lives: a pilot study of layperson tourniquet application. Acad Emerg Med. 2015;22(9):1113-1117.Google Scholar
15. Goolsby, C, Chen, E, Branting, A, et al. Analysis of layperson tourniquet application using a novel color-coded device. Disaster Med Public Health Prep. 2016;10(02):274-280.Google Scholar
16. Baruch, EN, Benov, A, Shina, A, et as. Does practice make perfect? Prospectively comparing effects of 2 amounts of practice on tourniquet use performance. Am J Emerg Med. 2016;34(12):2356-2361.Google Scholar
17. Eisenburger, P, Safar, P. Life supporting first aid training of the public—review and recommendations. Resuscitation. 1999;41(1):3-18.Google Scholar
18. Bolleter, S. Texas response agencies Stop the Bleed. JEMS. 2016;41(4):34.Google Scholar
19. Lorem, T, Steen, PA, Wik, L. High school students as ambassadors of CPR—a model for reaching the most appropriate target population? Resuscitation. 2010;81(1):78-81.Google Scholar
20. Kanstad, BK, Nilsen, SA, Fredriksen, K. CPR knowledge and attitude to performing bystander CPR among secondary school students in Norway. Resuscitation. 2011;82(8):1053-1059.Google Scholar
21. Lu, C, Jin, Y, Meng, F, et al. An exploration of attitudes toward bystander cardiopulmonary resuscitation in university students in Tianjin, China: a survey. Int Emerg Nurs. 2016;24:28-34.Google Scholar
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