Response to mass casualty events: from the battlefield to the Stop the Bleed campaign

Knudson, M. Margaret; Velmahos, George C.; Cooper, Zara

doi:10.1136/tsaco-2016-000023

Cited by 24 publications

(20 citation statements)

References 17 publications

(15 reference statements)

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“… 36 37 Non-legislative approaches, such as environmental modifications, policing practices, and bystander training, could also be worthy of evaluation in potentially preventing and reducing the tragic impacts of mass shootings. 38 39 40 41 As with other large-scale, population-wide solutions to relatively infrequent mass health threats, both legislative and non-legislative approaches should be carefully studied for their potential beneficial effects as well as any unintended consequences that could emerge. This caveat is applicable here given the low rate of mass shootings compared with daily shooting events, although certain solutions could benefit both events.…”

Section: Discussionmentioning

confidence: 99%

State gun laws, gun ownership, and mass shootings in the US: cross sectional time series

Reeping

Cerdá

Kalesan

et al. 2019

BMJ

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Objective To determine whether restrictiveness-permissiveness of state gun laws or gun ownership are associated with mass shootings in the US. Design Cross sectional time series. Setting and population US gun owners from 1998-2015. Exposure An annual rating between 0 (completely restrictive) and 100 (completely permissive) for the gun laws of all 50 states taken from a reference guide for gun owners traveling between states from 1998 to 2015. Gun ownership was estimated annually as the percentage of suicides committed with firearms in each state. Main outcome measure Mass shootings were defined as independent events in which four or more people were killed by a firearm. Data from the Federal Bureau of Investigation’s Uniform Crime Reporting System from 1998-2015 were used to calculate annual rates of mass shootings in each state. Mass shooting events and rates were further separated into those where the victims were immediate family members or partners (domestic) and those where the victims had other relationships with the perpetrator (non-domestic). Results Fully adjusted regression analyses showed that a 10 unit increase in state gun law permissiveness was associated with a significant 11.5% (95% confidence interval 4.2% to 19.3%, P=0.002) higher rate of mass shootings. A 10% increase in state gun ownership was associated with a significant 35.1% (12.7% to 62.7%, P=0.001) higher rate of mass shootings. Partially adjusted regression analyses produced similar results, as did analyses restricted to domestic and non-domestic mass shootings. Conclusions States with more permissive gun laws and greater gun ownership had higher rates of mass shootings, and a growing divide appears to be emerging between restrictive and permissive states.

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Section: Discussionmentioning

confidence: 99%

State gun laws, gun ownership, and mass shootings in the US: cross sectional time series

Reeping

Cerdá

Kalesan

et al. 2019

BMJ

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“…16 The widespread implementation of STB affords the opportunity to educate and empower the public to improve our local and national response to intentional and unintentional mass casualty events, which has shown to decrease preventable death rates. 17 In Arkansas, utilizing the NAEMT Tactical Emergency Casualty Care for Law Enforcement Officers and First Responders (TECC-LEO) curriculum, all law enforcement and EMS providers in the state have been trained and it has shown tangible results. In the early morning hours of July 1, 2017, an active shooter incident took place at the Power Ultra Lounge in downtown Little Rock.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhage-Control Training in Medical Education

Gowen

Sexton

Thrush

et al. 2020

Journal of Medical Education and Curricular Development

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Objectives: To evaluate and analyze the efficacy of implementation of hemorrhage-control training into the formal medical school curriculum. We predict this training will increase the comfort and confidence levels of students with controlling major hemorrhage and they will find this a valuable skill set for medical and other healthcare professional students. Methods: After IRB and institutional approval was obtained, hemorrhage-control education was incorporated into the surgery clerkship curriculum for 96 third-year medical students at the University of Arkansas for Medical Sciences using the national Stop The Bleed program. Using a prospective study design, participants completed pre- and post-training surveys to gauge prior experiences and comfort levels with controlling hemorrhage and confidence levels with the techniques taught. Course participation was mandatory; survey completion was optional. The investigators were blinded as to the individual student’s survey responses. A knowledge quiz was completed following the training. Results: Implementation of STB training resulted in a significant increase in comfort and confidence among students with all hemorrhage-control techniques. There was also a significant difference in students’ perceptions of the importance of this training for physicians and other allied health professionals. Conclusion: Hemorrhage-control training can be effectively incorporated into the formal medical school curriculum via a single 2-hour Stop The Bleed course, increasing students’ comfort level and confidence with controlling major traumatic bleeding. Students value this training and feel it is a beneficial addition to their education. We believe this should be a standard part of undergraduate medical education.

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“…The initiative was launched in the aftermath of the Sandy Hook shootings, and similar mass casualty events 7. It attempts to transfer the lessons learnt during the wars in Afghanistan and Iraq, relating to early hemorrhage control and the use of tourniquets, to the civilian setting 8. The programme seeks to inform, educate, and empower would-be bystanders to serve as immediate responders to save lives by control of hemorrhage at the scene of injury.…”

Section: Discussionmentioning

confidence: 99%

“…The initiative has been likened to the widespread provision of automated external defibrillators (AED), to facilitate early defibrillation in patients with cardiac arrest due to ventricular fibrillation. The increasing frequency of mass casualty events, particularly those involving ballistic injuries, has heightened awareness of the problem of the importance of early hemorrhage control in the United States 8…”

Section: Introductionmentioning

confidence: 99%

Stop the Bleed: gap analysis and geographical evaluation of incident locations

Tsui

Carroll

Dye

et al. 2020

Trauma Surg Acute Care Open

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BackgroundTrauma is a major public health issue. In 2015, the White House launched the “Stop the Bleed” (STB) campaign, which aims to equip would-be bystanders with the ability and equipment to assist in bleeding emergencies. This study sought to estimate the number of patients who might benefit from STB intervention, in an everyday setting, and their spatial injury profile.MethodsThis is a retrospective analysis of trauma registry and medical examiners’ data, collected between 2013 and 2017. The majority of patients were male. The median age was 32 years. Incidents were geocoded by ZIP code, and mapped using Quantum Geographic Information System (QGIS).ResultsWe identified 139 patients from medical examiner records and UAB’s trauma registry who might have benefitted from STB intervention. The number of incidents per year ranged from 22 to 35, averaging 2.3 incidents per month. There was no evidence of geographical clustering, although the small number of incidents precluded a formal geostatistical analysis.ConclusionThe number of patients who might benefit from STB interventions on a daily basis is small, and incident locations are difficult to predict. Educating the public in how to stop bleeding is appealing, but providing easy and widespread access to STB kits may be difficult. Although there are parallels to the provision of cardiopulmonary resuscitation and defibrillation for cardiac arrest, there are also differences, which should not be overlooked.

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Response to mass casualty events: from the battlefield to the Stop the Bleed campaign

Abstract: In the aftermath of a number of episodes of mass casualty events, we must be reminded of how important it is to be prepared and to reflect on the knowledge accumulated over the past 15 years of war in Iraq and Afghanistan.

Cited by 24 publications

References 17 publications

State gun laws, gun ownership, and mass shootings in the US: cross sectional time series

State gun laws, gun ownership, and mass shootings in the US: cross sectional time series

Hemorrhage-Control Training in Medical Education

Stop the Bleed: gap analysis and geographical evaluation of incident locations

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