268 - Stop the Bleed Training for Youth in Philadelphia

Publication Number: 2258.268

Priya P. Shah, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Rachel L. Rothstein, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Kyle Rice, The Children's Hospital of Philadelphia, New Castle, DE, United States; James E. Randolph, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Kristina Metzger, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; John Erbayri, Children's Hospital of Philadelphia, Ridley Park, PA, United States; Khoon-Yen Tay, Children's Hospital of Philadelphia, Philadelphia, PA, United States

Background: Children in Philadelphia are at disproportionate risk of traumatic injuries and face unique inequities in accessing subsequent healthcare. Created by the American College of Surgeons, Stop the Bleed® (STB) teaches lay bystanders how to recognize and acutely manage life-threatening hemorrhage, including direct pressure, wound packing and tourniquet application. Prior literature suggests that, with appropriate education, high school students can accurately recognize life-threatening hemorrhage and can confidently and correctly apply tourniquets.

Objective: Our goals were to improve: (1) youths' recognition of life-threatening hemorrhage, (2) youths' knowledge about direct pressure, wound packing and tourniquet application, and (3) access to bleeding control supplies in Philadelphia schools.

Design/Methods: Through our institution's Office of Community Impact, we received grant funding to provide school-based STB training for high school students and supply the schools with free bleeding control kits. In this cross-sectional study, students completed online training modules prior to attending one of three 60-minute, in-person hands-on training sessions. Students anonymously completed pre-session and post-session surveys to gauge their knowledge and confidence in controlling life-threatening bleeding utilizing a five-point Likert Scale with the option to provide open-ended qualitative feedback. Comparisons were made using the Wilcoxon rank-sum test given non-parametric data.

Results: In total, 62 students completed our STB program. After our training, participants more strongly agreed that timely bystander action can save lives (p = 0.008) and that public education in bleeding control techniques is important (p = 0.02). Students also reported an increase in personal confidence and preparedness in recognizing and responding to life-threatening bleeding (p < 0.001) [Table 1]. In the post-session survey, all respondents reported they would recommend the training to others. Qualitative comments highlighted the clarity of the training and the value of hands-on practice.

Conclusion(s): Training high school students in STB protocol offers a quick, effective way to boost youths' personal confidence and preparedness to manage life-threatening hemorrhage, as well as educate the public about the importance of bystander intervention during severe bleeding. Future steps include obtaining sustainable funding to offer free STB training and supplies to additional high schools in Philadelphia.

Table 1: Survey Responses Before and After Stop the Bleed Training for High School Students
Standard descriptive statistics with median (IQR) reported for pre-session and post-session survey responses on 5-point Likert scale (Strongly Disagree [1], Disagree [2], Neutral [3], Agree [4], Strongly Agree [5]). Given non-parametric data, comparisons were completed using the Wilcoxon rank-sum test. Bold denotes significant p-value <0.05.