P0108 - Stop the Bleed Training Increases High School Students’ Willingness, Comfort, and Knowledge to Address A Bleeding Injury.

Background: Uncontrolled bleeding is the leading cause of preventable death after injury. Stop the Bleed (STB) is a campaign to train civilians in the basic skills of external bleeding control. It has been shown to improve bleeding control knowledge and skills in adults. To reduce trauma mortality and bystander response disparities, widespread training of high school students has been proposed. This study aimed to assess the acceptability and efficacy of STB training for high school students.

Methods: We performed a STB training in a public high school in Seattle, Washington with 31 student participants. We performed pre- and post-session surveys. Participants were asked questions about motivations to learn STB, concerns regarding STB training, willingness and comfort with providing bleeding-injury first response, and knowledge of bleeding management. Surveys were paired using an anonymous code. For instances of unmatched results, the responses were summarized but not included in the paired analysis. The Wilcoxon-Pratt Signed Rank test was used for paired analysis of Likert scale questions, and McNemar’s chi-square test was used for paired analysis of questions with a binary response variable. Paired t-test was used for analysis of difference between mean proportion correct for knowledge-based questions.

Results: We received 31 responses to our pre-session survey, and 21 responses to our post-session survey. Approximately half (58%) of participants reported that trauma had impacted either themselves or a close relative or friend. Before the training, 80% expressed the belief that they will need to use it, and 88% disagreed with “teenagers should not have to try to save someone’s life.” After completing the training, participants were significantly more likely to be willing to try to stop bleeding (53% vs 94%, p=0.02). They also reported significantly increased comfort with most management skills (Figure 1). Similarly, the mean score on knowledge questions significantly improved (39% vs 87% correct, p=0.0001; Table 1). The proportion that agreed, “the topic might be scary” did not significantly change after the training. After the training, no participants felt the training would be harmful to their family or friends, and personal or family history of trauma did not impact participants’ opinion of the training being harmful (p=1).

Conclusion: Prior to participation in STB training at a public high school, most participants felt they would need to use the training, and that teenagers should try to save someone’s life. Comfort with bleeding control, willingness to provide bleeding injury first aid, and knowledge of bleeding control principles all improved after STB training. After the training, no participants were concerned about it being harmful, and participants with a personal or family history of trauma did not have increased concern about potential harm. More training sessions with high school participants are needed to confirm these results.