Surgeons on board with teaching public to stop bleeding in emergencies

(Reuters Health) - Just as many regular people have already learned CPR, members of the public can and should learn techniques to stop bleeding after mass-shooting events or everyday injuries, a survey of U.S. surgeons concludes.

“It’s a simple skill, which if you don’t have it, could lead to someone bleeding significantly and potentially dying,” said lead study author Lenworth Jacobs, director of the Hartford Hospital Trauma Institute in Connecticut.

“Our goal is to inform and empower the public because that first line of defense can really make a difference,” he told Reuters Health. “If someone drops in front of you, you want to feel like you can save a life.”

Jacobs and his colleagues tested their 15-minute bleeding control course, called B-Con, at a national meeting of surgeons in October 2016 by teaching 341 attendees techniques for stopping bleeding just as members of the public would be trained.

After the course, they surveyed the participating surgeons about whether they thought the training initiative was a good idea. Jacobs’ team found that 94 percent of the doctors agreed that teaching bleeding control should be a national priority. In addition, 93 percent said the course was at the right difficulty level to train citizens. About 82 percent said people would need a refresher course every two or three years to remember proper bleeding control techniques.

“In a previous survey across the country, we found that 90 percent of the public was interested in learning how to stop bleeding, which really surprised us,” Jacobs said. “What they don’t want is to feel frozen when something happens right in front of them.”

The training program, described on the website, teaches hemorrhage control skills, including direct pressure, wound packing and tourniquet application in extreme situations. The goal is to pair the course with CPR education to spread it nationwide.

After the shooting at Sandy Hook Elementary School in Connecticut in 2012, the American College of Surgeons created the Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events. Following the Boston Marathon bombing in 2013, the committee expanded their focus to all mass casualty events, as well as everyday events that result in severe bleeding, such as car accidents or kitchen knife mishaps.

The committee started a national initiative called Bystanders: Our Nation’s Immediate Responders, and the White House began the Stop the Bleed campaign in 2015 to encourage the public to learn bleeding control techniques. The B-Con course is the latest step toward make bleeding control instruction a nationwide program, Jacobs’ team writes in the Journal of the American College of Surgeons.

The campaign includes promotional efforts, Jacobs noted. For example, Rob Lowe and Marcia Harden, stars of the popular CBS show “Code Black,” did a one-minute public service announcement at the end of an episode that was seen by 7 million viewers. The American College of Surgeons is also encouraging schools and workplaces to put bleeding control kits next to automatic defibrillators.

“The world has changed. If we want to talk about building a resilient country, this is one thing everyone can do to help increase personal preparedness,” said Alexander Eastman, director of the trauma center at the University of Texas Southwestern Medical Center in Dallas.

Eastman, who wasn’t involved with the study, is part of a U.S. Department of Homeland Security team that has promoted the Stop the Bleed campaign.

“What surprises me is the willingness of Americans to help their fellow man or woman when they need it,” he told Reuters Health. “Previously, in shooter situations, we taught everyone to run and hide, and now people want to help, which hasn’t been documented before.”

A bleeding control program, however, must address concerns about seeing and touching blood, as well as getting an infection or causing additional harm to the injured person.

“Bleeding is not a reason for panic,” said George Velmahos, chief of trauma and critical care at Massachusetts General Hospital in Boston. Valmahos, who wasn’t involved with the study, is part of a team that will be teaching the B-Con course in high schools around Boston.

“The next step is clearly evaluating the effectiveness of this course for the public,” he told Reuters Health by email. “Is this just a nice exercise, or is the average citizen really likely to save a life? This research will be hard to do, but it’s necessary to prove this major effort is worthwhile.”

SOURCE: Journal of the American College of Surgeons, online May 10, 2017.