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In an emergency, Experts say ‘Stop the Bleed,’ Save a Life

A Marine with Combat Logistics Battalion 3 applies a tourniquet to a simulated casualty during a training exercise aboard Marine Air Ground Combat Center, Twentynine Palms, CA, in January. (Image credit: U.S. Marine Corps LCpl Conner Downey)

Campaign educates public on lessons learned in combat

By Sarah Marshall

Would you know what to do in an emergency – a car crash, an act of violence, a natural disaster – where others around you were bleeding profusely? Would you know what to do to “stop the bleed” and help save a life?

Gloved hands put a tourniquet on an upper thigh
U.S. Navy Hospital Corpsman 1st Class Robert F. Dotter with 2nd Medical Battalion, 2nd
Marine Logistics Group, applies a tourniquet to a Marine’s leg during simulated counter
improvised explosive device training at Camp Lejeune, N.C. (Image credit: U.S. Marine
Corps Lance Cpl. Tyler W. Stewart)
A White House-launched effort between several agencies, including the Uniformed Services University (USU), has been working to make sure the general public knows how to do just that.

“Stop the Bleed” is an initiative that launched in 2015 to teach citizens how to save lives from major trauma the same way bystanders would administer CPR to someone in cardiac arrest. Trauma is the leading cause of death in the U.S. for people between the ages of 1 and 40 and the initiative brings together numerous federal and private entities, public health groups, and medical societies, joining forces to educate and empower citizens to stop life-threatening hemorrhage after unintentional injuries. Hemorrhaging, in particular, accounts for nearly 40 percent of deaths in the first 24 hours after a traumatic injury, according to the National Center for Injury Prevention and Control.


But “Stop the Bleed” isn’t quite like other public education campaigns, explained Dr. Craig Goolsby, science director of USU’s National Center for Disaster Medicine and Public Health. It’s based on important lessons learned on the battlefield and a decade of research by the U.S. military. Faced with a record number of vascular trauma and extremity injuries from high-velocity gunshot wounds and explosive devices during the wars in Iraq and Afghanistan, the military began to quickly re-assess and revamp its tactical combat casualty care. Troops were equipped with individual first aid kits, containing tourniquets and newly-created hemostatic dressings to control severe blood loss. Simultaneously, training had been revamped to educate both medical and non-medical forces, emphasizing immediate recognition and control of blood loss with their newly designed tool kit – and these efforts paid off. Military studies showed that immediate control of severe blood loss in fact significantly decreased preventable deaths on the battlefield.

With this knowledge, the military and a wide array of organizations joined forces, along with members of the Hartford Consensus – a committee that formed in the wake of the tragic Sandy Hook school shooting. Together, they worked to push these lessons learned in the military out to the public, which led to the White House launching the “Stop the Bleed” campaign.

“We want people to understand how to provide lifesaving support, we want people to have access to lifesaving support kits, and we want them to know the phrase ‘Stop the Bleed,’” Goolsby said.

A military medical student talks to an event patron about Stop The Bleed
Faculty, students, and staff from the Uniformed Services University’s National Center for Disaster Medicine and Public Health recently participated in the Baltimore Health Expo to raise awareness about the national “Stop the Bleed” initiative. While at the expo, they were able to recruit many participants for a new study they are conducting, along with the University of Virginia, looking at which techniques are easiest for the layperson to use to help control blood loss in an emergency. (Image credit: Sarah Marshall)
As part of this initiative, a team at USU recently published two studies – a third has been accepted for publication – looking at the lay person’s ability to apply tourniquets, and measuring which tactics are most effective for teaching the public how to actually apply these techniques. Goolsby said that they have found even an untrained person can effectively apply a tourniquet by learning on the spot – or what they refer to as having “just in time” training. Based on their findings, the lay person will know what to do to “stop the bleed” about 50 percent of the time with “just in time” training, he said. However, if they have just 15 minutes of web-based training combined with “just in time” instructions, the success rate for applying tourniquets jumps to 75 percent.

“We think just a little bit of instruction ahead of time, combined with ‘just in time’ training, can allow people to be successful,” he said.

A military member practices putting a tourniquet on the arm of another military member
Bangladesh and Malaysian service members practice applying a tourniquet while in a class on
medical techniques during an exercise. (Image credit: U.S. Marine Corps photo by Lance Cpl.
Adam Montera)
Goolsby’s team of researchers, including staff from USU’s NCDMPH and Department of Military and Emergency Medicine, in collaboration with the University of Virginia in Charlottesville, Va., are also conducting a fourth study as part of these efforts. They are looking at the usability of several types of dressings to control severe blood loss, called hemostatic dressings, and Goolsby said they hope to help determine which would be easiest for the layperson to use. Recently their team, which included several USU medical students, went to a Baltimore Health Expo to collect data by recruiting participants for this study and to educate them about the importance of “stopping the bleed” to help save a life.

“It’s a disseminated effort. There are lots of people working in different ways to support the campaign,” Goolsby said. The Red Cross is incorporating these efforts into its first aid training, for example, and the Department of Homeland Security has launched a new website to push out educational materials.

There are many tragedies, unfortunately, around the country each day, Goolsby said, and if people knew what to do in these circumstances – like just knowing to simply kneel down on a bleeding wound – they might help to save a life. This is about educating the public and making them aware of what to do, and getting them access to the right equipment, Goolsby said. It’s an effort to translate lessons learned on the battlefield to benefit the American public.
For more information about “Stop the Bleed,” visit www.stopthebleed.usuhs.edu.