M. Araujo1, F. Cai1, R. Lei1, E. E. Fox1, C. E. Wade1, S. D. Adams1 1McGovern Medical School at UTHealth,McGovern Medical School,Houston, TX, USA
Introduction: Uncontrolled bleeding is the main cause of preventable traumatic death and the arrival of first responders may be delayed due to safety concerns. The educational “Stop the Bleed” program was created to train non-medical bystanders with skills to control hemorrhagic wounds until first responders arrive, potentially saving lives. Prior studies found that 1-hour hands-on instruction an effective method to teach these techniques. We hypothesized that a realistic bleeding simulator would improve the quality and impact of this training.
Methods: Third year medical students (MS3) and non-medical summer students (NMS) underwent “Stop the Bleed” training. Each student was given an anonymous identifier to track results and was randomized into standard “DRY” model or realistic “WET“ bleeding simulator groups. After a didactic lecture by a certified instructor they each had hands-on training to pack wounds and place tourniquets. Students completed pre and post surveys to evaluate baseline knowledge, teaching effectiveness, and willingness and preparedness to intervene to help a bleeding stranger. They were observed placing a tourniquet and packing a wound, timed and evaluated on technique. Statistical significance, set at p? 0.05, was analyzed using T-test and the Likert scale by Wilcoxon-signed ranked test.
Results: Students (n=360) were trained in bleeding control techniques (241 MS3, 119 NMS) and stratified between WET (n=171) and DRY models (n=189). Results were excluded if unpaired or incomplete. While both groups demonstrated improved average correct of 5 knowledge questions after training (MS3 3.9 to 4.8, NMS 3.3 to 4.2) there was a significant difference in the NMS compared to the MS both before and after. Both groups had a similar and significant increase in willingness and preparedness to help a bleeding stranger after training, irrespective of the method. Compared to the DRY teaching model, students on the WET model needed more correction on technique and significantly more time for tourniquet placement (DRY: 50 sec, WET: 62 sec). For wound packing, however, students on the WET model were faster (DRY: 72 sec, WET: 62 sec), but this could be attributed to different packing spaces between the models.
Conclusions: Students receiving training in bleeding control techniques are confident and empowered to aid a bleeding victim irrespective of method. Students on the WET tourniquet model voiced anxiety due to the active “bleeding”, and were visibly fumbling, which may account for the longer time to placement. This may be a better representation of the real world experience, and may help them overcome those anxieties to intervene while still in a training situation.
