Nationally, uncontrolled bleeding is the leading cause of preventable death in trauma (Ezeibe et al). In the USA alone, more individuals die from trauma-related incidents (ie, motor vehicle collisions, homicides) compared with any other cause, outside of cardiovascular disease and cancer (Ezeibe et al). This high incidence rate of mortality due to uncontrolled hemorrhage presents an opportunity to save lives and provide public health benefit. Through the large-scale implementation of Stop The Bleed training for the lay-public, the number of preventable deaths by uncontrolled hemorrhage in trauma can be decreased, and thousands of lives can be saved.

In the United States, uncontrolled bleeding contributes to the highest amount of preventable deaths due to trauma in the prehospital setting. Uncontrolled hemorrhage in the prehospital setting is highly fatal, as bleeding that is left untreated may rapidly decrease a patient’s chance of survival and lead to exsanguination. A lack of lay-public training in treating uncontrolled hemorrhage has had a large effect on these statistics. Hemorrhage in the prehospital setting can easily become fatal if the time to control this hemorrhage is prolonged. Results suggest that survival after severe trauma is not only a matter of short rescue time but more a matter of well-used rescue time including performance of vital measures already in the prehospital setting (Klein et al). The efficient use of prehospital time can be the difference between life and death for a patient. The lack of lay-public training in controlling bleeding quickly and effectively affects patient outcomes tremendously. With prehospital time being of such importance, a lack of critical interventions given to the patient in order to positively affect outcome in this phase of care is detrimental, and increases mortality rates due to uncontrolled bleeding. This high mortality rate due to uncontrolled bleeding, paired with a high incident-rate for motor vehicle accidents, leaves many thousands of individuals at risk of death due to hemorrhage.

Currently, this problem is being addressed by the Department of Defense (DoD henceforth). The DoD has created the Stop The Bleed (STB henceforth) initiative, a non-profit organization dedicated to training the lay-public on how to control hemorrhage effectively. This program has been successful in some ways, with many individuals receiving training on how to stop bleeding before ambulances arrive. There is substantial investment in layperson and first responder training involving tourniquet use for hemorrhage control (Barnard et al). This STB training has resulted in much higher proficiency in the lay-public on how to control bleeding in the prehospital setting. Knowledge related to hemorrhage control increased following the STB course. Participants who engaged in hands-on practice for tourniquet and wound packing were more proficient than those who only saw the lecture (Zwislewski et al). This proficiency and training given to the lay-public on how to stop bleeding allows for more efficient use of prehospital time, positively affecting patient outcomes. Citizens who are typically bystanders have the ability to be immediate responders during trauma, and save lives before ambulances arrive. Efforts to increase access and early tourniquet use can provide public health benefit (Barnard et al).

Due to the importance of effective use of prehospital time, and the rate of mortality in patients affected by massive hemorrhage, more citizens should be trained to stop uncontrolled bleeding before ambulances arrive. Through further large-scale implementation of Stop The Bleed training, citizens will be able to become immediate responders and save lives that would otherwise perish. This ability to become an immediate responder presents an immediate public health benefit, with a large percentage of preventable deaths being stopped by this training. Become an immediate responder; take a Stop The Bleed course and gain the knowledge and skills to save a life when it matters most.

Works Cited

Barnard LM;Guan S;Zarmer L;Mills B;Blackwood J;Bulger E;Yang BY;Johnston P;Vavilala MS;Sayre MR;Rea TD;Murphy DL; “Prehospital Tourniquet Use: An Evaluation of Community Application and Outcome.” The Journal of Trauma and Acute Care Surgery, U.S. National Library of Medicine, 1 June 2021, pubmed.ncbi.nlm.nih.gov/34016927/.

Ezeibe, Chibuike, et al. “Haemorrhage Control in the Prehospital Setting: A Scoping Review Protocol.” BMJ Open, BMJ Publishing Group, 27 July 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6661646/.

Klein, Konstantin, et al. “Is Prehospital Time Important for the Treatment of Severely Injured Patients? A Matched-Triplet Analysis of 13,851 Patients from the Traumaregister DGU®.” BioMed Research International, Hindawi, 20 June 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6610751/.

Zwislewski A, Nanassy AD, Meyer LK, Scantling D, Jankowski MA, Blinstrub G, Grewal H, Europe. “Practice Makes Perfect: The Impact of Stop the Bleed Training on Hemorrhage Control Knowledge, Wound Packing, and Tourniquet Application in the Workplace.” Europe PMC, 29 Mar. 2019, europepmc.org/article/med/30967272.