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Learner's Stop the Bleed Outcomes Between Lay Instructor and Emergency Medical Services (EMS)-Trained Instructor

Jeffrey L Pellegrino1, Stephen E Smith1, Abigail Nolan2

  • 1Emergency Management and Homeland Security, The University of Akron, Akron, USA.

Cureus
|October 26, 2023
PubMed
Summary

Lay instructors can effectively teach life-saving bleeding control skills. Both lay and emergency medical services (EMS)-trained instructors achieved comparable outcomes in a Stop the Bleed course, demonstrating that experience is not a barrier to effective instruction.

Keywords:
american red crossfirst aidhemorrhage controlinstructorlife-threatening bleedingstop the bleed™tourniquet

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Area of Science:

  • Medical Education
  • Public Health
  • Emergency Medicine

Background:

  • The "Bleeding Control Basic (BCon) course v. 1.0" requires instructors to have specific healthcare credentials, limiting the potential workforce for vital bleeding control training.
  • Alternative Stop the Bleed courses, like the American Red Cross First Aid for Severe Trauma (FAST) course, do not have these stringent instructor requirements.
  • This difference raises questions about learner outcomes when courses are taught by instructors with varying levels of formal healthcare or emergency medical services (EMS) credentials.

Purpose of the Study:

  • To compare learner outcomes in skill (tourniquet application), knowledge (cognitive assessment), and attitude (Intention to Aid) between lay instructors and EMS-trained instructors.
  • To evaluate the effectiveness of lay instructors in facilitating a standardized Stop the Bleed course.

Main Methods:

  • Learners' outcomes were assessed after training by either lay instructors or EMS-trained instructors in the FAST program.
  • All instructors received identical training as new facilitators within the FAST program.
  • Outcomes measured included proper tourniquet application (skill), scores on the Stop the Bleed Educational Assessment Tool (SBEAT) (knowledge), and the Intention to Aid (I2A) survey (attitude).

Main Results:

  • All learners (n=135) successfully applied a tourniquet, demonstrating comparable skill acquisition regardless of instructor background.
  • Learners taught by EMS-trained instructors (mean age 25.5) scored significantly higher on the SBEAT knowledge assessment (90.0 vs. 83.9, p=0.001) compared to those taught by lay instructors (mean age 16.6).
  • No statistical difference was found in the learners' intention to aid in bleeding emergencies between the two groups.

Conclusions:

  • Lay instructors and EMS-trained instructors are comparably effective in delivering a standardized Stop the Bleed course.
  • Prior lay experience with tourniquets should not preclude individuals from becoming Stop the Bleed instructors.
  • Standardized curricula and instructor development programs enable individuals with diverse backgrounds to effectively teach life-saving bleeding control competencies.