Rafael Consunji (Doha / QA), Ahammed Mekkodathil (Doha / QA), Husham Abdelrahman (Doha / QA), Ayman El-Menyar (Doha / QA), Ruben Peralta (Doha / QA), Sandro Rizoli (Doha / QA), Hassan Al-Thani (Doha / QA)
Introduction
Most preventable trauma deaths occur within 1 hour of injury due to uncontrolled bleeding. For this reason, training lay first-person responders in trauma care, with a focus on hemorrhage control, has been recommended.
Objectives
This systematic review will analyze the effect of the STOP THE BLEED (STB) training course on the knowledge, skill, and attitudes of lay first-person responders.
Methods
PubMed and Google Scholar databases were used to identify relevant peer-reviewed research articles describing evaluations of STB courses for laypersons from 1 December 2013 to 31 October 2022. A hand search of article references was also undertaken. Studies were included if: they implemented the STB course; trainees were laypersons, and they included some type of outcome measures such as knowledge, skill, confidence gained, willingness to provide or utilization of care provided to and outcomes of trauma patients.
Results
The database searches yielded 2,893 unique papers. We retained 33 papers for fulltext review, resulting in 24 eligible papers. Grey literature and manual searches yielded 11 additional publications, for a total of 35 studies. The most reported finding was a statistically significant increase in hemorrhage control knowledge or tourniquet application skill in 26 studies. Twenty-two studies reported statistically significant improvements in willingness, confidence, comfort, and likelihood to respond to a bleeding patient, and six studies reported significant reductions in the retention of bleeding control.
Conclusion
STB courses for laypersons have demonstrated significant improvements in knowledge, skill, confidence, and willingness to intervene to stop traumatic exsanguination. The evaluation of clinically relevant patient outcomes, specifically their effect on preventable deaths from traumatic exsanguination, is needed to strengthen further the evidence behind the recommendations for the more widespread teaching of the "STB" course.
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