A. Maitland1, K. W. Sexton1, A. Bhavaraju1, W. C. Beck1, B. Davis1, M. K. Kimbrough1, R. Robertson1, K. Buckner1, J. R. Taylor1 1University Of Arkansas for Medical Sciences,Trauma Surgery,Little Rock, AR, USA
Introduction: Hemorrhage continues to be the leading cause of early death after traumatic injury. To prevent death from hemorrhage, local law enforcement officers and first responders are being trained to "Stop the Bleed". In the year 2015, and going forward, each individual was trained using these bleeding control techniques and were equipped with CAT tourniquets. We hypothesized that this would improve early survival for victims of penetrating trauma.
Methods: Registry data were used from a level 1 trauma center for all penetrating ballistic injuries. Exclusion criteria included patients from outside the center's county, patients not arriving directly from the scene of injury, suicide or self-injury, an event of pre-hospital cardiac arrest, a maximum AIS for the Head and Neck body regions =3, and a maximum AIS for the extremity body region =2. Univariate and bivariate statistics were performed using JMP Pro 13.2.0 (SAS: Cary, NC)
Results: In a final study population of 455 patients, overall ED mortality was 4.84%. The ED mortality rate in the pre-training group was 7.00% (21/300), and 0.65% (1/155) in the post-training group, which was a significant difference (p=0.0005). A nominal logistic regression model was performed. In this model, ED systolic blood pressure >90mmHg (p<0.0001), ED pulse rate <120bpm (p=0.000329), and injury occurrence after law enforcement training (p=0.00498) were significant predictors of survival
Conclusion: Local Law Enforcement Officer and First responder hemorrhage training can improve the early survival rate of patients with a penetrating injury. Further work needs to be done to determine the full impact of this training.
