Educating and Empowering Inner-City High School Students in Bleeding Control

Abstract

Introduction: Unintentional bleeding is the leading cause of death in people 1-44 years of age in the United States. The Stop the Bleed (STB) campaign is a nationwide course that teaches the public to ensure their own safety, call 911, find the bleeding injury, and achieve temporary hemorrhage control by several techniques. Although the national campaign for the training course was inspired by active shooter events, the training can be applied to motor vehicle accidents and small-scale penetrating and gunshot wounds. Extending the audience to inner-city high school students in a violence-prone neighborhood has the potential to save lives if they are first on the scene. Objectives: We hypothesized that students would have a greater degree of comfort, willingness, and preparedness to intervene in acute bleeding after taking the course. Methods: This was a prospective, interventional pilot study in one inner-city high school in Brooklyn, New York. Students were given the option to participate in the STB course with pre- and postsurveys. We recruited 286 students from physical education or health education class to take a 50-minute bleeding control training course. Mean age was 15.7 years old. Students were divided into groups of 20-25 and taught by 2-3 emergency medicine, pediatric, or trauma surgery STB instructors. Each course included 2-3 skills stations for placing a tourniquet, wound packing, and pressure control. Results: Prior to the course, only 43.8% of the students reported being somewhat likely or very likely to help an injured person who was bleeding. After the course, this increased to 80.8% of students even if no bleeding control kit was available. Additionally, there were significant improvements in self-rated comfort level from pre- to post-course 45.4% to 76.5%, and in self-rated preparedness from 25.1% to 83.8%. All three measures showed statistically significant improvement, P <.0001. Conclusion: Teaching the STB course to high school students from a community with high levels of violence resulted in increased comfort level, willingness, and preparedness to act to control bleeding. If these opinions translate into action, students’ willingness to act could decrease pre-hospital blood loss and empower youth to perform life-saving interventions.

A framework for the design and implementation of Stop the Bleed and public access trauma equipment programs

“…Examples of organizations that have taken the lead for training in their communities include EMS agencies, local trauma centers, non‐profits, faith‐based organizations, and other service organizations. Bleeding control education should be included as part of other existing training programs: first aid courses, cardiopulmonary resuscitation (CPR) courses, life‐saving courses, etc. High school age students have successfully demonstrated being able to learn bleeding control techniques 53–54 Specific populations should also be targeted for bleeding control education: public safety personnel, security personnel at large event venues, industrial and construction workers, anyone taught CPR, and high school students. Due to the variety of commercial tourniquets available, we recommend that a given community's training program include familiarization with the type of equipment contained in that community's bleeding control kits.…”

“…Bleeding control education should be included as part of other existing training programs: first aid courses, cardiopulmonary resuscitation (CPR) courses, life‐saving courses, etc. High school age students have successfully demonstrated being able to learn bleeding control techniques 53–54 …”

Learner’s Stop the Bleed Outcomes Between Lay Instructor and Emergency Medical Services (EMS)-Trained Instructor Groups

“…Accidents in the home, in traffic, and in the workplace are common occurrences that many people will experience at some point in their lives, with the potential to cause life-threatening bleeding; they also then have the opportunity to take life-saving action [ 1 , 2 ]. As the leading cause of death from traumatic injury is blood loss, early recognition, appropriate intervention, and activation of the emergency medical system, are needed to reduce sequelae and mortality.…”