Background
In a decade, the US military reduced deaths from uncontrolled bleeding on the battlefield
by 67%. This success, coupled with an increased incidence of mass shootings in the
US, has led to multiple initiatives intent on translating hemorrhage-control readiness
to the civilian sector. However, the best method to achieve widespread population-level
hemorrhage-control readiness for civilians has not yet been elucidated. This study
evaluates the implementation of American College of Surgeons Bleeding Control training
at a National Football League stadium as a prospective model for general mass gathering
site implementation.
Methods
The American College of Surgeons’ Bleeding Control Basic layperson hemorrhage-control
training was implemented at Gillette Stadium in Massachusetts. The five domains are
as follows: reach (demographics of study participants), effectiveness (correct tourniquet
application after intervention), adoption (investigator, leadership, and participant
efforts for sustainability of intervention), implementation (course details), and
maintenance (correct tourniquet application at retention testing at 3 to 9 months).
Results
A total of 562 employees were included in the study. Of those included employees,
58.7% reported having taken first-aid training and 17.3% reported having taken hemorrhage-control
training. There was an increased mean likelihood to help (4.39 vs 4.09, P < .01) and comfort level to control hemorrhage (4.26 vs 3.60, P < .01) after training compared with before training, on a Likert scale (1–5). The
stadium operations team located hemorrhage control kits with automatic external defibrillators,
integrated layperson immediate-response awareness into its Web site, and developed
a public safety announcement. The training, performed by physicians, nurses, and emergency
medical technicians, consisted of a 30-minute lecture and a 30-minute hands-on skills-training
course, with a class size of 24. The total number of sessions was 24.
Conclusion
Achieving initial hemorrhage-control readiness and maintenance at a mass gathering
site through American College of Surgeons Bleeding Control training is feasible but
requires significant commitment from training staff, site leadership, and financial
resources.
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Article info
Publication history
Published online: November 10, 2018
Accepted:
October 1,
2018
Received in revised form:
September 14,
2018
Received:
August 4,
2018
Footnotes
Partially funded by the Gillian Reny Stepping Strong Center for Trauma Innovation and Gillette Stadium, Foxborough MA.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
