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

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.

The FAST VIP (First Aid for Severe Trauma "Virtual" in-Person) Educational Study.

INTRODUCTION: Trauma is the leading cause of death for young Americans. Increased school violence, combined with an emphasis on early hemorrhage control, has boosted demand to treat injuries in schools. Meanwhile, coronavirus disease 2019 (COVID-19) has made educating the public about trauma more difficult. A federally funded high school education program in development, called First Aid for Severe Trauma™ (FAST™), will teach students to aid the severely injured. The program will be offered in instructor-led, web-based, and blended formats. We created a program to prepare high school teachers to become FAST instructors via "virtual" in-person (VIP) instruction. We used a webinar followed by VIP skills practice, using supplies shipped to participants' homes. To our knowledge, no prior studies have evaluated this type of mass, widely distributed, VIP education. METHODS: This study is a prospective, single-arm, educational cohort study. We enrolled a convenience sample of all high school teachers attending FAST sessions at the Health Occupations Students of America-Future Health Professionals International Leadership Conference. Half of the participants were randomized to complete the Stop the Bleed Education Assessment Tool (SBEAT) prior to the webinar, and the other completed it afterward; SBEAT is a validated tool to measure learning of bleeding competencies. We then performed 76 VIP video-training sessions from June-August 2020. The FAST instructors assessed each participant's ability to apply a tourniquet and direct pressure individually, then provided interactive group skills training, and finally re-evaluated each participant's performance post-training. RESULTS: A total of 190 (96%) participants successfully applied a tourniquet after VIP training, compared to 136 (68%) prior to training (P < 0.001). Participants significantly improved their ability to apply direct pressure: 116 (56%) pre-assessment vs 204 (100%) post-assessment (P < 0.001). The mean score for the SBEAT increased significantly from pre-training to post-training: 2.09 with a standard deviation (SD) of 0.97 to 2.55 post-training with a SD of 0.72 (P < 0.001). CONCLUSION: This study suggests that a webinar combined with VIP training is effective for teaching tourniquet and direct-pressure application skills, as well as life-threatening bleeding knowledge. VIP education may be useful for creating resuscitative medicine instructors from distributed locations, and to reach learners who cannot attend classroom-based instruction.