High-School Students Can Stop the Bleed: A Randomized, Controlled Educational Trial

Craig Goolsby; Luis E Rojas; Raphaelle H Rodzik; Marianne Gausche-Hill; Matthew D Neal; Matthew J Levy

doi:10.1016/j.acap.2020.05.012

High-School Students Can Stop the Bleed: A Randomized, Controlled Educational Trial

Acad Pediatr. 2021 Mar;21(2):321-328. doi: 10.1016/j.acap.2020.05.012. Epub 2020 May 27.

Authors

Craig Goolsby¹, Luis E Rojas², Raphaelle H Rodzik², Marianne Gausche-Hill³, Matthew D Neal⁴, Matthew J Levy⁵

Affiliations

¹ Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences (C Goolsby), Bethesda, Md; National Center for Disaster Medicine and Public Health (C Goolsby, LE Rojas, and RH Rodzik), Rockville, Md. Electronic address: craig.goolsby@usuhs.edu.
² National Center for Disaster Medicine and Public Health (C Goolsby, LE Rojas, and RH Rodzik), Rockville, Md; The Henry M. Jackson Foundation for the Advancement of Military Medicine (LE Rojas and RH Rodzik), Bethesda, Md.
³ Los Angeles County Emergency Medical Services Agency (M Gausche-Hill), Los Angeles, Calif; Departments of Emergency Medicine and Pediatrics, David Geffen School of Medicine at the University of California (M Gausche-Hill), Los Angeles, Calif; Departments of Emergency Medicine and Pediatrics, Harbor-UCLA Medical Center (M Gausche-Hill), Torrance, Calif.
⁴ Departments of Surgery, Critical Care Medicine, and the Clinical and Translational Science Institute (CTSI), University of Pittsburgh (MD Neal), Pittsburgh, Pa; University of Pittsburgh Medical Center (MD Neal), Pittsburgh, Pa.
⁵ Department of Emergency Medicine, Johns Hopkins University School of Medicine (MJ Levy), Baltimore, Md; Howard County Department of Fire and Rescue Services (MJ Levy), Columbia, Md.

PMID: 32473216
DOI: 10.1016/j.acap.2020.05.012

Abstract

Objective: To determine high-school students' ability to learn hemorrhage control skills and knowledge via 3 educational modalities.

Background: Trauma is the leading cause of death for young Americans, and there are calls to teach children about hemorrhage control. However, little is known about adolescents' ability to perform hemorrhage control, and the ideal way(s) to teach them.

Methods: This randomized controlled trial enrolled high-school students from 39 states at a 2019 national conference. After answering questions about their willingness to use tourniquets, participants received hemorrhage control education in 1 of 3 formats: instructor-led, web-only, or blended (combining web and instructor-led). Participants were then assessed on their ability to apply a tourniquet and to identify wounds that require a tourniquet. Finally, they completed an attitude questionnaire.

Results: Two hundred and four (82%) of 248 participants applied a tourniquet correctly: 72 (88%) instructor-led, 50 (61%) web-only, and 79 (94%) blended. The instructor-led and blended arms were superior to the web-only arm (P < .001). Nearly all participants passed an assessment requiring them to identify wounds warranting a tourniquet (99% instructor-led and blended, and 98% web-only). All modalities improved participants' self-reported willingness and comfort in using tourniquets (P < .001).

Conclusions: This is the first study to demonstrate that high-school students can learn hemorrhage control via multiple methods. Blended and instructor-led education led to highly successful skill performance. Students learned to identify wounds requiring tourniquets and showed an improved willingness to aid from all modalities. These findings should encourage educators to offer multiple educational modalities.

Keywords: Stop the Bleed; hemorrhage control; high-school students; medical education; simulated; tourniquet.

Published by Elsevier Inc.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adolescent
Child
Hemorrhage* / therapy
Humans
Schools
Students
Surveys and Questionnaires
Tourniquets*
United States