E. G. Andrade1, J. M. Hayes1, L. J. Punch1 1Washington University,Acute & Critical Care Surgery,St. Louis, MO, USA
Introduction: Injury is the leading cause of death for individuals aged 1-44 years old in the United States. More specifically, gun violence (GV) is the leading cause of death for black males aged 15-24, outweighing the nine following most common causes of death combined. Hemorrhage is the leading cause of preventable trauma death. Thus, bystander abillity to control life-threatening hemorrhage is an important area for intervention to decrease preventable trauma deaths. We sought to ascertain if the Bleeding Control (BC) 1.0 course from the American College of Surgeons (ACS) is effective in teaching hemorrhage control to community members (CM) and medical professionals (MP) and if the provision of BC kits influences participant willingness to intervene in the setting of life-threatening bleeding.
Methods: Faculty and volunteers from a level 1 trauma center held BC courses on location for CM and on site for medical students, surgical residents, and surgical staff. The course was taught in concordance with the standards set for BC 1.0 by the American College of Surgeons. Participants then assembled their own BC kits, which included personal protective equipment, a combat application tourniquet, hemostatic gauze, adhesive compression tape, a permanent marker, and trauma shears. Pre- and post-course surveys were administered to assess exposure to severe bleeding (SB), knowledge of BC technique, and willingness to intervene with and without the kit. Surveys were compared using Pearson's chi-squared.
Results: Eighty CM and sixty MP completed BC training. Personal exposure to SB varied greatly between groups; among CM, 54% had experienced SB in themselves, a relative or close friend, compared with 13.6% in MP. After BC training, confidence among MP to stop life-threatening bleeding improved from 25.9% to 83.6%(p< 0.01). For CM, confidence improved from 6.7% to 57%(p<0.01). With BC training and the BC kit, 88.3% of MP and 91% of CM reported there was no reason why they could not stop life-threatening bleeding. When asked to consider their ability to stop life-threatening bleeding after the course without a BC kit, 53.8% of MP were confident compared with 36.1% of CM.
Conclusion: Although participants with a medical background start at a higher level of confidence with bleeding control techniques, both groups had significant improvement in their level of confidence with stopping life threatening bleeding after taking the BC course. The importance of the bleeding control kit was more evident in the community group.
