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Updated: Oct 5, 2025

Integrated Compensatory Responses in a Human Model of Hemorrhage

Integrated Compensatory Responses in a Human Model of Hemorrhage

Published on: November 20, 2016

Recommendations for Improving Stop the Bleed: A Systematic Review.

Ryoma Nichols¹, Jordan Horstman²

¹Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202-2131, USA.

Military Medicine

|January 27, 2022

Summary

The Stop the Bleed (StB) initiative effectively boosts bystander confidence in managing bleeding emergencies. However, improvements are needed in skill retention, outcome data collection, and identifying all beneficial settings for training.

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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.