Creating Model Stop the Bleed Training Programs at Three Distinct Institutions

Abstract

After the 2012 mass shooting at Sandy Hook Elementary School, the ACS convened the Hartford Consensus with the goal of maximizing survival in mass-casualty and intentional violence events. The consensus suggested that outcomes of traumatic injury would improve if health-care providers had increased training in hemorrhage management and in addition, if bystanders received sufficient training to initiate efforts to control hemorrhage. Consensus recommendations included1 creation of a public-access hemorrhage-control training program and2 the distribution and availability of publicaccess hemorrhage-control equipment. Together, these would empower citizens to treat life-threatening hemorrhage before first responder arrival.1 To meet the need, the ACS Committee on Trauma and National Association of Emergency Medical Technicians created the Bleeding Control Basic course, a one-hour class on hemorrhage control designed to train individuals with any level of inexperience. In addition, the Department of Homeland Security created the Stop the Bleed (STB) campaign to support the Hartford Consensus efforts. Since 2015, the Bleeding Control class has been taught to more than 848,090 participants through fire departments, hospitals, and other organizations, but many other groups have yet to take advantage of the opportunity.2 This study models sustainable STB programs at distinct institutions in the Northeast and MidAtlantic United States and demonstrates the programs’ successes. Three sites and populations were chosen for STB training programs. These sites included medical professionals, first responder providers, and secondary school students and faculty. The Frank H. Netter MD School of Medicine at Quinnipiac University (QU) is a North Haven, CT-based American Council for Graduate Medical Education (ACGME)-accredited allopathic medical school founded in 2010 with approximately 100 students per class. The Georgetown Day School (GDS) is a nonsectarian private school for pre-Kindergarten through 12th grade founded in 1945 with 120 students per class. The Cabin John Park Volunteer Fire Department (CJPVFD) is an allvolunteer organization founded in 1930 with 60 trained responders that provides fire and rescue services in Montgomery County, MD. STB presentation materials and training equipment are available to eligible instructors at the ACS STB website. Purchase of ACS training equipment was an investment of each site. Eligible trainers are qualified to register as instructors and deliver courses after receiving initial education from a certified STB instructor. Between January and December 2018, a total of 43 bleeding control classes were conducted and provided free to the learners at the three locations (QU: 30, GDS: 7, and CJPVFD: 6). At QU, a total of 547 learners (235 medical and nursing students, 193 undergraduate students, 28 faculty, 16 facilities staff, and 75 public safety officers) were educated. At GDS, 251 learners (246 high school students, five staff members) were educated over seven classes. At CJPVFD, 29 volunteer firefighters and EMS providers were educated over six classes. Each location also contributed a moderate percentage of attendees who went on to become instructors, and several participated in the delivery of subsequent courses. At QU, 34 medical students, two nursing students, 1 undergraduate student, 2 faculty members, and 2 public safety officers (total 41) registered as instructors or associate instructors after the training. Thirty-three (80%) of the instructors assisted in delivery of a subsequent course. After the courses at GDS, 5 faculty members were to register as instructors. At CJPVFD, 17 participants became certified instructors. Seven (41%) have since taught a course. Address correspondence and reprint requests to Jeremy I.G. Fridling, B.A., N.R.E.M.T.-P., T.P.-C., Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Road, North Haven, CT 06473. E-mail: Jeremy.fridling@ quinnipiac.edu.