Recommendations for Improving Stop the Bleed: A Systematic Review

Area of Science:

• Public Health
• Emergency Medicine
• Trauma Care

Background:

• The Hartford Consensus identified critical needs for improving survivability in mass casualty events, particularly active shooter incidents.
• Key recommendations included earlier recognition and treatment of life-threatening hemorrhage, leading to the development of the Stop the Bleed (StB) Campaign.
• The StB Campaign aims to empower laypersons to provide immediate aid for severe bleeding emergencies.

Approach:

• A systematic narrative review was conducted to evaluate the American College of Surgeons (ACS) StB Initiative.
• Searches utilized terms such as "Stop the Bleed," "bleeding control," "first-aid," and bystander interventions.
• Inclusion criteria focused on civilian settings, bystander first aid, and StB curriculum components, resulting in the analysis of 56 relevant articles.

Key Points:

• The StB program significantly enhances short-term confidence among laypersons in managing bleeding emergencies.
• Identified areas for improvement include skill retention over time and the need for more robust data collection on patient outcomes.
• Gaps were noted in understanding the full range of settings where StB training would be beneficial and in optimizing instructor selection.

Conclusions:

• The StB initiative excels at building immediate confidence in bystanders, representing its primary strength.
• Further development of curriculum materials and training modalities is recommended to address identified gaps.
• Refined research methodologies are necessary to better quantify the program's long-term impact and effectiveness.