Division of Trauma, Department of Surgery, Burns, Acute and Critical Care, Weill Cornell Medicine, New York, New York.
Department of Nursing, New York-Presbyterian Hospital / Weill Cornell Medical Center, New York, New York.
J Surg Res. 2020 Nov;255:627-631. doi: 10.1016/j.jss.2020.02.004. Epub 2020 Jul 10.
The "Stop the Bleed" (StB) campaign aims to educate laypersons on performing bleeding control techniques in any setting that requires hemorrhage control, such as motor vehicle crashes or mass casualty incidents. Participants undergo a didactic and practical session, the latter incorporating a mannequin. We hypothesized that participants would increase content knowledge after StB participation and that the training could be improved by a more life-like bleeding modification of the mannequin.
From July 2017 to January 2018, hospital and community members from a major metropolitan area participated in StB training. Participants provided demographic data regarding prior emergency training and were asked pre- and post-test questions (five-point Likert scale) regarding their response to hemorrhage. Individuals also evaluated the mannequin on bleeding simulation. Scores were reported as means with standard deviation or medians with interquartile ranges (IQRs) with subset analysis stratified by experience.
Of 402 participants, 310 provided complete data. On the composite, pre-test self-assessment, participants had a median score of 24 of 30 points (IQR 16-30). Post-testing demonstrated a statistically significant increase with a median score of 29 (IQR 25-30, P < 0.05). Subset analysis by prior emergency training (n = 102) demonstrated that both those with prior emergency training and those with no prior emergency training had significant improvement. On evaluation of the mannequin, participants reported that a more realistic model would increase their confidence in technique. Both subgroups reported that training would be enhanced if the mannequins were more realistic.
StB is an effective education program. Those without prior experience or training in hemorrhage cessation demonstrated the most improvement. Regardless of background, participants reported overwhelmingly that the training would be more effective if it were more realistic. Future work to design and develop cost-effective mannequins demonstrating pulsatile blood flow and cessation of hemorrhage could enable learners to actually "Stop the Bleed".
“停止出血”（StB）运动旨在教育非专业人员在任何需要控制出血的环境中进行出血控制技术，如车祸或大规模伤亡事件。参与者接受理论和实践课程，后者包括使用人体模型。我们假设参与者在参与 StB 后会增加内容知识，并且通过更逼真的人体模型出血修改可以改进培训。
从 2017 年 7 月至 2018 年 1 月，来自一个大都市区的医院和社区成员参加了 StB 培训。参与者提供了有关先前紧急培训的人口统计学数据，并在出血前和后测试问题（五点李克特量表）回答他们对出血的反应。个人还评估了人体模型的出血模拟。分数以平均值加标准差或中位数加四分位距（IQR）报告，并按经验进行亚组分析。
在 402 名参与者中，有 310 名提供了完整的数据。在综合、前测自我评估中，参与者的中位数得分为 30 分中的 24 分（IQR 16-30）。测试后，中位数得分显著增加到 29 分（IQR 25-30，P<0.05）。按先前紧急培训的亚组分析（n=102）表明，无论是具有先前紧急培训还是没有先前紧急培训的人都有显著的改善。在评估人体模型时，参与者表示更逼真的模型会增加他们对技术的信心。两个亚组都报告说，如果人体模型更逼真，培训将得到增强。
StB 是一个有效的教育计划。那些没有先前止血经验或培训的人表现出最大的改善。无论背景如何，参与者都压倒性地表示，如果培训更逼真，培训将更有效。未来的工作是设计和开发具有脉动血流和止血效果的经济高效的人体模型，使学习者能够真正“停止出血”。
