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Bystander Training to Help ‘Stop the Bleed’

Johns Hopkins joins nationwide initiative to empower bystanders in case of a mass casualty event.

Staff in the Department of Emergency Medicine at
The Johns Hopkins Hospital practice Stop the Bleed
techniques during a training session.

When a mass casualty event happens, such as a shooting or a bombing, victims can die from blood loss within five minutes. Since it could take several minutes for emergency medical services (EMS) personnel to arrive, patients often have the best chance of survival if bystanders provide immediate care to bleeding victims. With this in mind, Johns Hopkins has joined a nationwide training initiative to help “Stop the Bleed” in case of such events.

Stop the Bleed is an awareness campaign and a call to action launched by the White House in October 2015 that encourages bystanders to become trained, equipped and empowered to help control bleeding before professional help arrives. March 31 has been designated as National Stop the Bleed Day.

The initiative stems from the Hartford Consensus, recommendations to minimize deaths from mass shootings that were was initially released in the wake of the deadly attack at Sandy Hook Elementary School in Connecticut in 2012. “The Hartford Consensus acknowledged the great strides the military has made on the battlefield in reducing preventable deaths — anyone in battle is trained in bleeding control,” says Matthew Levy, D.O., associate professor of emergency medicine in the Johns Hopkins University School of Medicine, who was part of several of the Hartford Consensus meetings. “If a patient’s bleeding can be controlled through interventions like applying tourniquets prior to the onset of shock, the patient has a much higher rate of survival.”

With Stop the Bleed, participants receive training to help victims in a mass casualty event. Participants learn to control bleeding by applying pressure to the wound using dressing or clothing, or with a tourniquet.

One of the groups taking up the charge in Maryland, the Maryland Region III Health and Medical Coalition, which includes health and medical professionals in the Baltimore area, came together in fall 2017 to create several hundred catastrophic bleeding kits for local hospitals and public health buildings. The kits have supplies used to stop bleeding, including tourniquets, hemostatic gauze, gloves and other materials. Dianne Whyne, CEPAR’s director of operations, had a leadership role in the project’s development through her involvement in the coalition. “The face of disasters has changed through the years, and we need to be prepared for mass casualty incidents,” Whyne says. “Developing the catastrophic bleeding kits just made sense.”

Around Johns Hopkins

At The Johns Hopkins Hospital, the catastrophic bleeding kits will be installed in certain automated external defibrillator (AED) boxes around the East Baltimore campus. The Office of Emergency Management team, which is leading the effort at the hospital, is currently identifying high-traffic areas to place the kits. Teams from around the hospital, including the Department of Emergency Medicine, Division of Acute Care Surgery and the CPR office, are spearheading training of medical and nonmedical staff, such as corporate security officers and adult emergency department staff, to use materials in the kits.

Both Johns Hopkins Bayview Medical Center and Howard County General Hospital also received kits and are in the process of identifying staff to be trained and locations of the kits. Leaders at The Johns Hopkins University are considering implementing Stop the Bleed training for faculty and staff.

“While the catalyst for the Stop the Bleed initiative was mass shootings and terrorist attacks, the techniques and tools can be used in response to any everyday trauma to help patients control bleeding,” says Levy, who is also the chair of the Stop the Bleeding Coalition.

Several Johns Hopkins faculty and staff are also involved in training members of the community in Stop the Bleed techniques. Through his work, Levy and colleagues from across Johns Hopkins and throughout the state have recently trained students and teachers at a Howard County high school as well as school nurses, among other groups.

Levy and other Johns Hopkins faculty and staff are also participating in a number of bystander bleeding control research projects, including identifying the best way to train nonclinical people in the methods and reviewing records to better understand hemorrhage-related deaths.

“We hope people will never have to use the Stop the Bleed training,” Levy says. “However, the goal is to empower them to do something about severe bleeding injuries if they are ever faced with such a tragic event.”