Recommendations for Placement of Bleeding Control Kits in Public Spaces-A Simulation Study.

Area of Science:

• Emergency Medicine
• Public Health
• Trauma Surgery

Background:

• Public access to bleeding control (BAC) measures can significantly reduce trauma-related fatalities.
• Strategic placement of bleeding control kits (BCKs) in public areas is crucial for enabling timely bystander intervention.
• Mass casualty incidents (MCIs) necessitate effective strategies for public safety and immediate medical response.

Purpose of the Study:

• To investigate the impact of different public bleeding control kit placement strategies on casualty survival in a simulated mass casualty incident.
• To compare the effectiveness of co-locating BCKs with automated external defibrillators (AEDs) versus other distribution models.

Main Methods:

• A computer simulation of a bomb explosion in a shopping mall was developed.
• Parameters included casualty numbers, public willingness to assist, and injury types, informed by evidence and expert opinion.
• Four BCK placement strategies were evaluated: co-located with AEDs (90-second intervals), dispersed (10 locations), and near 1 or 2 exits.

Main Results:

• Co-locating BCKs with AEDs at 90-second walking intervals yielded the highest number of surviving victims (18.2).
• Dispersing 10 kits evenly throughout the mall resulted in a slightly lower survival rate (18.0).
• Placing kits at one or two main exits led to the fewest survivors (15.9 and 16.1).

Conclusions:

• Co-locating bleeding control kits with AEDs at 90-second walking intervals is the optimal strategy for improving casualty outcomes in simulated mass casualty incidents.
• Strategic placement, rather than just availability, of BCKs is critical for maximizing survival in public spaces.
• This finding supports the integration of bleeding control resources into existing public safety infrastructure like AED placement.