C. Villegas1, S. Liu1, J. Rosenberg1, R. Winchell1, M. Narayan1 1Weill Cornell Medical College,The Division Of Trauma, Burns, Critical And Acute Care Surgery,New York, NY, USA
Introduction:
The “Stop the Bleed” (StB) campaign was instituted to educate laypersons on how to perform bleeding control techniques in the event of mass casualty events that result in life-threatening hemorrhage. Participants currently undergo a 90-min instructional and practice session, the latter incorporating a mannequin on which participants practice. We hypothesized participants would 1) increase content knowledge after StB participation: and 2) find that the training could be improved by a more life-like modification of the mannequin.
Methods:
From July 2017 to January 2018, hospital and community members from a major metropolitan area participated in StB training. Participants provided demographic data regarding prior emergency training and experience and were asked pre- and post-test questions (5-point Likert scale) regarding likelihood of and confidence in responding to hemorrhage. Individuals also evaluated the mannequin on whether it would improve their education if it were more life-like. Scores were reported as medians with interquartile ranges (IQR). Wilcoxon paired and unpaired tests were used as appropriate to evaluate differences with α=0.05 and subset analysis stratified by experience.
Results:
Of 402 participants, 310 had complete data on demographic and outcome data of interest. On a composite, pre-test self-assessment of willingness and confidence to respond to hemorrhage in emergency situations, participants had a median score of 24 out of 30 points (IQR 19-27). Post-testing demonstrated a statistically significant increase with a median score of 29 (IQR 26-30, p < 0.05). Participants’ composite score on mannequin realism assessing compression, packing, and tourniquet application was 13 out of 15 (IQR 12-15), yet the participants reported that more realistic model would increase their confidence in technique (median 15, IQR 12-15). Subset analysis of those individuals without prior training or experience in emergency response or hemorrhage control (n=117) demonstrated that they had the largest gains in pre- and post-test differentiation (median difference 8.5, IQR 4.3-12.0) compared to those with prior experience (n=193, median difference of 3.0, IQR 0.0-6.0, p <0.05). Both subgroups reported that training would be enhanced if the mannequins were more realistic (median 15, IQR 12-15 for both groups).
Conclusion:
StB is an effective education program resulting in improved confidence in wound compression, packing, and tourniquet application. Those without prior experience or training in hemorrhage cessation demonstrated the most improvement. Regardless of background, participants overwhelmingly reported that the training would be more effective if it were more realistic. Future work to design and develop cost-effective mannequins demonstrating cessation of hemorrhage is required to enable learners to actually “Stop the Bleed”.