Stopping the Bleed: Can Just-in-Time Training Improve the Tourniquet Application Competencies of Bystanders and First Responders? – A Randomized Control Trial

Abstract

Background/Introduction:

Public education in effective interventions for external hemorrhage control for gunshot wounds has become a priority focus. There remains a gap in training programs of populations of non-medical bystanders who would be the first to stop this bleeding in a mass shooting.

Objectives:

To create a WHO EMT initiative community training program designed to close this gap in low-middle income countries, complex humanitarian events and in conflict zones.

Method/Description:

This study is a factorial randomized control study, utilizing four cohort groups. Two comprised of bystanders with no previous medical training, and the remaining two comprised of first responders previously trained to control external hemorrhage. Each group was put through the same hemorrhage control simulation; one cohort of each bystander/first responder groups acted as a respective control group receiving only a tourniquet, whereas other cohorts of each group received Stop-the-Bleed® handouts to serve as the point-of-care instructional method of Just-in-Time training alongside the tourniquets.

Results/Outcomes:

Within the bystander’s cohort, 26.3% of the group who received JiT training applied the tourniquet correctly vs 6.3% of the control group.

Of the first responder’s cohort, 75% of those who received JiT training applied the tourniquet correctly vs 66.7% of the control group.

There was no statistically significant difference in the ability to correctly apply the tourniquet in the intervention vs control groups of either cohort.

Conclusion:

The WHO EMT initiative has the opportunity to train non-medical bystanders to receive Just-in-Time training to effectively place a tourniquet to stop the bleeding after a mass shooting.