Marjory Stoneman Douglas High School, Parkland, Fla., students resume classes today after the summer break. They will be greeted and protected by a new fence with guarded or locked access points, more security staff and more school resource officers. It’s been six months since 17 students and teachers were killed and 17 were injured by an armed gunman.
As we continue to cast about for solutions to prevent mass murder inside our schools, it’s unsurprising that the Department of Homeland Security is offering a $1.8 million grant to an awardee to develop a program and training curriculum to teach high school students to use tourniquets. The School-Age Trauma Training grant aims to train teens on how to “assist victims with traumatic injuries” in emergency situations before responders arrive.
Immediate control of severe hemorrhage with tourniquets like the SWAT-T and Combat Application Tourniquet, as well as tourniquets improvised from materials at hand, like belts, strips of clothing and backpack straps, is critical to reducing mortality from penetrating trauma. Occupants inside soft targets, like schools, churches, and stores and other public spaces, will always be vulnerable to well-armed gunmen intent on causing maximum death and injury. Preparing as many people as possible to move, escape or attack, along with lifesaving first aid skills, is sensible public policy.
First aid training for teens
Like many EMS professionals, the Boy Scouts of America First Aid merit badge, was my introduction to medicine. The Boy Scouts, Girl Scouts, American Red Cross and other youth-serving organizations have been teaching first aid skills to teens for a century. Millions of teens have learned and used their first aid training while in school and throughout life.
CPR and AED instruction has become a legislated high school graduation requirement in many states. It’s likely that the Stop the Bleed curriculum will also become a mandatory curriculum item for students. Perhaps legislators will also consider requiring adults to learn tourniquet application as a requirement for driver’s license renewal or purchasing a hunting license.
EMS needs to lead bleeding control training
EMS, especially our educators and training officers, is uniquely prepared and qualified to develop the School-Age Trauma Training curriculum and training process. EMS is present in every community and has existing connections in the communities’ schools. Every emergency medical responder, EMT and paramedic already has bleeding control knowledge, experience applying tourniquets and other hemorrhage control products, and the professional stature to teach students. As the prehospital care-giving experts, we are the best people to teach prehospital care.
The National Association of EMTs trains thousands of new and experienced providers every year in trauma care through Prehospital Trauma Life Support, Tactical Casualty Combat Care and Tactical Emergency Casualty Care. As an NAEMT member, I’d like to see the NAEMT – with its experience developing prehospital training, national network of instructors, and organizational infrastructure to create and distribute a training program – apply for the DHS School-Age Trauma Training grant.
Bleeding control training already exists
The Bleeding Control Course (BCon) is designed for individuals who have little or no medical training, like most high school students, but who may have the opportunity to care for a severe bleeding victim before EMS arrives. Any EMS provider who completes the BCon course can become a BCon instructor. In about an hour, students view a bleeding control presentation and complete two skill stations – tourniquet application and wound packing.
“Implementation of Stop the Bleed on an Undergraduate College Campus” outlines the steps the Johns Hopkins University campus EMS program, Hopkins Emergency Response Organization (HERO), took to train their personnel, campus police and other students in the Stop the Bleed curriculum. Sixty-six HERO EMTs completed the BCon course and as BCon instructors, HERO personnel taught over 500 additional people (Howard County 9th Grade High School Students, first-year JHU School of Medicine Students, local houses of worship attendees, and many Baltimore County Private School Nurses) in the first four months of their Stop the Bleed program.
Bleeding control equipment must be easily accessible
For the School-Age Trauma Training grant to have maximum impact on saving lives from severe hemorrhage, the project needs to ensure:
- Training is widely disseminated to every high school student in the U.S.
- Barriers to training completion, such as internet access and instructor availability, are minimized.
- Courses, curriculum guides and instructional materials are available at no cost to schools.
- Bleeding control kits are ubiquitous in school classrooms, hallways and common areas.
The HERO Stop the Bleed program spent $9,500 on:
- 46 bleeding control kits.
- 14 mass-casualty kits.
- 2 bleeding control wound packing trainers.
- 25 Combat Application Tourniquets for use during training.
Many public schools will need to seek out donations or grant funding to purchase bleeding control kits and training materials. Partnering with an EMS agency or fire department might improve the likelihood of a school receiving grant funding for bleeding control training and products.
Direct pressure on teens to save lives
Unlike CPR training mandates, where teens prepare to save the lives of older adults, a tourniquet training curriculum is much more likely to prepare teens to save the life of a peer. Traumatic injury, from all causes, is a leading cause of death and injury for teens and young adults. Bleeding control skills are more likely to be used by teens who are nearby when a classmate, friend or coworker is injured.
Are you already teaching BCon to high school students? What are your lessons learned from teaching teens to save other teens?
