Can they stop the bleed? Evaluation of tourniquet application by individuals with varying levels of prior self-reported training.

Abstract

BACKGROUND:

Application of extremity tourniquets is a central tenet of multiple national initiatives to empower laypersons to provide hemorrhage control (HC). However, the efficacy of the general population who self-report prior first-aid (FA) or HC training on individual's ability to control bleeding with a tourniquet remains unknown. Therefore, the objective of this study was to assess the effectiveness of laypeople with self-reported prior FA or HC training to control bleeding with a tourniquet.

STUDY DESIGN:

Employees of a stadium were assessed via simulation in their ability to apply a Combat Application Tourniquet. As a subgroup analysis of a larger study, participants who self-reported: 1) No prior training, 2) FA training only or 2) FA + HC training were compared. Logistic regression adjusting for age, gender, education, willingness-to-assist, and comfort level in HC was performed.

RESULTS:

317 participants were included. Compared to participants with no prior training (14.4%,n = 16/111), those with FA training only (25.2%,n = 35/139) had a 2.12-higher odds (95%CI:1.07-4.18) of correct tourniquet application while those with FA + HC (35.8%,n = 24/67) had a 3.50-higher odds (95%CI:1.59-7.72) of correct application. Participants with prior FA + HC were more willing-to-assist and comfortable performing HC than those without prior training (p < 0.05). However, reporting being very willing-to-assist [OR0.83,95%CI:0.43-1.60] or very comfortable [OR1.11,95%CI:0.55-2.25] was not associated with correct tourniquet application.

CONCLUSION:

Self-reported prior FA + HC training, while associated with increased likelihood to correctly apply a tourniquet, results in only 1/3 of individuals correctly performing the skill. As work continues in empowering and training laypeople to act as immediate responders, these findings highlight the importance of effective layperson education techniques.

• Authors: Justin C McCarty, Edward J Caterson, Muhammed A Chaudhary, Juan P Herrera-Escobar, Zain G Hashmi, Scott A Goldberg, Craig Goolsby, Stuart Lipsitz, Adil H Haider, Eric Goralnick
• Journal: Injury (Injury) Vol. 50 Issue 1 Pg. 10-15 (Jan 2019) ISSN: 1879-0267 [Electronic] Netherlands
• PMID: 30274758 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Emergency Treatment
• Extremities (blood supply, injuries)
• Female
• First Aid
• Health Promotion
• Hemorrhage (prevention & control, therapy)
• Humans
• Male
• Middle Aged
• Patient Simulation
• Prospective Studies
• Self Report
• Shock, Hemorrhagic (prevention & control)
• Task Performance and Analysis
• Time Factors
• Tourniquets
• Volunteers
• Wounds and Injuries (therapy)