Defining a Research Agenda for Layperson Prehospital Hemorrhage Control: A Consensus Statement

Area of Science:

• Trauma and Emergency Medicine
• Public Health Research
• Medical Education and Training

Background:

• Trauma is a leading cause of death in young US adults, with uncontrolled hemorrhage being a primary driver of mortality.
• Military advancements in prehospital hemorrhage control have significantly reduced battlefield deaths.
• A unified research approach for civilian layperson prehospital hemorrhage control is lacking.

Purpose of the Study:

• To establish a national research agenda for prehospital hemorrhage control by laypersons.
• To guide future research and funding priorities in civilian trauma care.
• To address research gaps in implementation, epidemiology, education, and logistics.

Main Methods:

• Convened the National Stop the Bleed (STB) Research Consensus Conference (February 27-28, 2019).
• Utilized a 3-round modified Delphi consensus process with subject matter experts, leaders, and government/foundation representatives.
• Incorporated a scoping review on layperson hemorrhage control prior to the consensus process.

Main Results:

• Generated consensus on 113 high-priority research questions from an initial 487 submissions.
• The final prioritized agenda includes 24 key research questions across 5 themes: epidemiology/effectiveness (8), materials (4), education (9), global health (2), and health policy (1).
• Identified critical research gaps to enhance layperson capabilities in managing life-threatening hemorrhage.

Conclusions:

• The National STB Research Consensus Conference successfully prioritized a research agenda for layperson hemorrhage control.
• This agenda provides a roadmap for investigators and funding agencies to reduce preventable trauma deaths.
• The findings are crucial for advancing civilian prehospital care and improving outcomes for bleeding emergencies.