World trauma education: hemorrhage control training for healthcare providers in India

Abstract

BackgroundHemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India.MethodsA cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant. In total, 88 healthcare providers’ responses were analyzed. Three bleeding control skills were presented: wound compression, wound packing, and tourniquet application.ResultsAmong participants, only 23.9% had received prior bleeding control training. Participants who reported feeling ‘extremely confident’ responding to an emergency medical situation rose from 68.2% prior to StB training to 94.3% post-training. Regarding hemorrhage control abilities, 37.5% felt extremely confident before the training, compared with 95.5% after the training. For wound packing and tourniquet application, 44.3% and 53.4%, respectively, felt extremely confident pre-training, followed by 97.7% for both skills post-training. Importantly, 90.9% of StB trainees felt comfortable teaching newly acquired hemorrhage control skills. A significant majority of participants said that confidence in their wound packing and tourniquet skills would improve with more realistic mannequins.ConclusionTo our knowledge, this is the first StB training in India. Disparities in access to care, long transport times, and insufficient numbers of prehospital personnel contribute to its significant trauma burden. Dissemination of these critical life-saving skills into this region and the resulting civilian interventions will increase the number of trauma patients who survive long enough to reach a trauma center. Additionally, considerations should be given to translating the course into local languages to increase program reach.Level of EvidenceLevel IV.

Evaluation of bleeding control course for health‐care providers in Japan

“…The ACS certified BCon program has trained over 1 million people in 71 countries worldwide to date 6 . Several studies have reported the efficacy of the BCon course in the USA 9,10 and other countries 9,11–13 . In Spain, it was reported that the BCon course was evaluated as good for relevance, usefulness, applicability, and satisfaction by most of the studied population 13 .…”

“…6 Several studies have reported the efficacy of the BCon course in the USA 9,10 and other countries. 9,[11][12][13] In Spain, it was reported that the BCon course was evaluated as good for relevance, usefulness, applicability, and satisfaction by most of the studied population. 13 In India, the vast majority of participants said that they had a high degree of confidence in their wound packing and tourniquet skills.…”

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

“…There have been a few studies in India which analyzed the need for the stop the bleed training in trauma. These studies reported the necessity for training adult responders in bleeding control [10] [11] [12]. In a rural south Indian district, 81.4% of survey respondents did not have adequate skills to manage an emergency before training, but were willing to acquire knowledge and skills to help victims [10].…”

“…In a rural south Indian district, 81.4% of survey respondents did not have adequate skills to manage an emergency before training, but were willing to acquire knowledge and skills to help victims [10]. Stop the bleed training for adult healthcare providers (resident and attending physicians and nurses) showed encouraging results where 95% showed improved confidence and competence after the training, including wound packing and tourniquet application [11].…”