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. 2024 Dec;50(6):2775-2798.
doi: 10.1007/s00068-023-02422-6. Epub 2024 Feb 14.

Can "Stop The Bleed" training courses for laypersons improve hemorrhage control knowledge, skills, and attitudes? A systematic review

Rafael Consunji  1 , Ahammed Mekkodathil  2 , Husham Abdelrahman  3 , Ayman El-Menyar  4   5 , Ruben Peralta  3   6 , Sandro Rizoli  3 , Hassan Al-Thani  3
Affiliations

Can "Stop The Bleed" training courses for laypersons improve hemorrhage control knowledge, skills, and attitudes? A systematic review

Rafael Consunji et al. Eur J Trauma Emerg Surg. 2024 Dec.

Abstract

Background: In many regions of the world, most trauma deaths occur within 1-2 h of injury due to uncontrolled bleeding. For this reason, training lay first-person responders in trauma care, focusing on hemorrhage control, has been recommended. We hypothesized that STOP THE BLEED (STB) training courses that teach laypersons how to stop traumatic compressible bleeding immediately are needed to potentially prevent deaths due to hemorrhage. This systematic review will analyze the effect of the STB training course on the knowledge, skill, and attitudes of lay first-person responders for hemorrhage control.

Methods: PubMed and Google Scholar databases were used to identify relevant peer-reviewed research articles describing evaluations of STB courses for laypersons from December 1 2013 to October 31 2022. In addition, a hand search of article references was undertaken. Studies were included if they implemented the STB course; trainees were laypersons, and the study had some outcome measures such as knowledge, skill, confidence gained, and willingness to provide or utilization of care provided to and outcomes of trauma patients.

Results: The database searches yielded 2,893 unique papers. We retained 33 articles for full-text review, resulting in 24 eligible papers. Gray literature and manual searches yielded 11 additional publications for a total of 35 studies. The most reported finding was a statistically significant increase in hemorrhage control knowledge or tourniquet application skills in 26 studies. Twenty-two studies reported statistically significant improvements in willingness, confidence, comfort, and likelihood to respond to a bleeding patient, and 6 studies reported substantial reductions in the retention of bleeding control knowledge or skills. Only one study reported on the effect on patient outcomes.

Conclusion: STB courses for laypersons have demonstrated significant improvements in knowledge, skill, confidence, and willingness to intervene to stop traumatic exsanguination. The evaluation of clinically relevant patient outcomes, specifically their effect on preventable deaths from traumatic exsanguination, is needed to strengthen further the evidence behind the recommendations for more widespread teaching of "STB" courses.

Keywords: Causality; Course; Injury; Layperson; Review; Stop the bleed; Training; Trauma.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest. Ethical statement: Not applicable for this review article. Informed consent: Not applicable.

Figures

Fig. 1
Fig. 1
Flow chart on selection of articles for review
See this image and copyright information in PMC

References

    1. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000;90:523. - DOI - PMC - PubMed
    1. Sauaia A, Moore FA. Moore EE et al epidemiology of trauma deaths: a reassessment. J Trauma. 1995;38:185–93. - DOI - PubMed
    1. Abdelrahman H, El-Menyar A, Al-Thani H, Consunji R, Zarour A, Peralta R, Parchani A, Latifi R. Time-based trauma-related mortality patterns in a newly created trauma system. World J Surg. 2014;38(11):2804–12. 10.1007/s00268-014-2705-x. (PMID: 25099683). - DOI - PubMed
    1. Zhang ZY, Zhang HY, Talmy T, Guo Y, Zhou SR, Zhang LY, Li Y. Management of non-compressible torso hemorrhage: an update. Chin J Traumatol. 2021;24(3):125–31. 10.1016/j.cjtee.2021.03.005. - DOI - PMC - PubMed
    1. Mock CN, Goosen J, Joshipura M, Peden M. Guidelines for essential trauma care. Geneva: The World Health Organization; 2004.

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