Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.
West J Emerg Med. 2022 Feb 14;23(2):186-191. doi: 10.5811/westjem.2021.12.52581.
Unintentional bleeding is the leading cause of death in people 1-44 years of age in the United States. The Stop the Bleed (STB) campaign is a nationwide course that teaches the public to ensure their own safety, call 911, find the bleeding injury, and achieve temporary hemorrhage control by several techniques. Although the national campaign for the training course was inspired by active shooter events, the training can be applied to motor vehicle accidents and small-scale penetrating and gunshot wounds. Extending the audience to inner-city high school students in a violence-prone neighborhood has the potential to save lives if they are first on the scene.
We hypothesized that students would have a greater degree of comfort, willingness, and preparedness to intervene in acute bleeding after taking the course.
This was a prospective, interventional pilot study in one inner-city high school in Brooklyn, New York. Students were given the option to participate in the STB course with pre- and post-surveys. We recruited 286 students from physical education or health education class to take a 50-minute bleeding control training course. Mean age was 15.7 years old. Students were divided into groups of 20-25 and taught by 2-3 emergency medicine, pediatric, or trauma surgery STB instructors. Each course included 2-3 skills stations for placing a tourniquet, wound packing, and pressure control.
Prior to the course, only 43.8% of the students reported being somewhat likely or very likely to help an injured person who was bleeding. After the course, this increased to 80.8% of students even if no bleeding control kit was available. Additionally, there were significant improvements in self-rated comfort level from pre- to post-course 45.4% to 76.5%, and in self-rated preparedness from 25.1% to 83.8%. All three measures showed statistically significant improvement, P <.0001.
Teaching the STB course to high school students from a community with high levels of violence resulted in increased comfort level, willingness, and preparedness to act to control bleeding. If these opinions translate into action, students' willingness to act could decrease pre-hospital blood loss and empower youth to perform life-saving interventions.
在美国，1-44 岁人群中，非故意出血是导致死亡的首要原因。“停止出血（Stop the Bleed，STB）”运动是一项全国性课程，旨在教导公众确保自身安全、拨打 911、找到出血损伤，并通过几种技术实现暂时的出血控制。尽管该培训课程的全国性运动是受活跃枪手事件的启发，但该培训也可应用于机动车事故和小规模穿透性及枪伤。如果在暴力频发的社区内向市中心高中的学生推广该课程，那么如果他们能第一时间到达现场，他们就有潜力拯救生命。
我们假设学生在参加课程后，在干预急性出血方面会有更高程度的舒适度、意愿和准备度。
这是在纽约布鲁克林市的一所市中心高中进行的一项前瞻性、干预性试点研究。学生可以选择参加 STB 课程，并在课前和课后进行调查。我们从体育或健康教育课中招募了 286 名学生参加 50 分钟的出血控制培训课程。平均年龄为 15.7 岁。学生被分成 20-25 人的小组，由 2-3 名急诊医学、儿科或创伤外科 STB 讲师授课。每门课程包括 2-3 个技能站，用于放置止血带、伤口填塞和压力控制。
在课程之前，只有 43.8%的学生表示他们有可能或非常有可能帮助正在出血的受伤者。在课程之后，这一比例增加到 80.8%的学生，即使没有出血控制包可用。此外，学生的自我评估舒适度水平从课前的 45.4%显著提高到课后的 76.5%，自我评估准备程度从课前的 25.1%提高到课后的 83.8%。所有这三个衡量标准都显示出统计学上的显著改善，P<.0001。
向来自暴力高发社区的高中生教授 STB 课程，提高了他们控制出血的舒适度、意愿和准备度。如果这些意见转化为行动，学生的行动意愿可能会减少院前失血量，并赋予年轻人进行救生干预的能力。
