26 Jul Modifying ‘Stop the Bleed’ Campaign to Emphasize Pressure and Packing

MedicalResearch.com Interview with:

Dr. McCarty

Justin C. McCarty, DO, MPH
General Surgery Resident, PGY-4
Department of Surgery | St. Elizabeth’s Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The main finding of the paper is that the assumption of the training that teaching how to apply one type of tourniquet translates to knowledge and understanding of how to apply any other tourniquet is questionable.

I love the Stop the Bleed campaign and what it stands for but I believe that it is important that as it moves forward that there is continuous questioning of the educational curriculum and how it is delivered. Currently, I question whether the best interim method of teaching and empowering laypeople is to focus more on pressure and packing of wounds; a skill that is always fully translatable, doesn’t require anything other than a willing set of hands, and is incredibly effective, rather than tourniquets.

A second question I have is whether existing tourniquets and the associated training are approaching the issue from the right angle since to me the device should be designed to not require training and continuous practice, but rather should be intuitive and simple to use, features lacking from all existing devices.  

MedicalResearch.com: What should readers take away from your report?

Response: I believe the physicians should continue to discuss bleeding control with patients and institutions should offer courses and let participants know that 99.9% of bleeding they are ever likely to encounter can be controlled with pressure and packing alone.

For those areas where there is potential greater risk (though still still rare) such as mass gathering areas or high crime areas, tourniquet training can be taught but it should be delivered and informing trainees that they are being taught a single device and that improvising a tourniquet is ineffective and would detract from applying pressure and packing. 

Citation:

McCarty JC, Hashmi ZG, Herrera-Escobar JP, et al. Effectiveness of the American College of Surgeons Bleeding Control Basic Training Among Laypeople Applying Different Tourniquet Types: A Randomized Clinical Trial. JAMA Surg. Published online July 24, 2019. doi:10.1001/jamasurg.2019.2275

https://jamanetwork.com/journals/jamasurgery/fullarticle/2738052

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Last Updated on July 26, 2019 by Marie Benz MD FAAD