Stop the Bleed San Antonio: A Public Health Education Project Focused on Hemorrhage Control and the use of Tourniquets

Elliot M Ross, The University of Texas School of Public Health


Background: The “Stop the Bleed” campaign advocates for non-medical personnel to be trained in basic hemorrhage control and that "bleeding control kits" be available in high-risk areas. However, it is not clear which tourniquets are most effective in the hands of laypersons. The objective of this pilot study was to determine which tourniquet type was the most intuitive for a layperson to apply correctly. Methods: This project is a randomized study derived from a “Stop the Bleed” education initiative conducted by the UT Health San Antonio Office of the Medical Director between SEP 2016 and MAR 2017. Novice tourniquet users were randomized to apply one of three commercially available tourniquets (Combat Action Tourniquet (CAT; North American Rescue, LLC), Ratcheting Medical Tourniquet, (RMT; M2 Inc.) or Stretch Wrap and Tuck, SWAT-T; TEMS Solutions, LLC) in a controlled setting. Individuals with formal medical certification, prior military service and or prior training with tourniquets did not meet the layperson criteria and were excluded from participation. The primary outcome in our study was correct tourniquet placement. Results: Of 236 possible participants, 203 met the eligibility criteria. Demographics were similar across groups. The rates of successful tourniquet application for the RMT, SWAT-T, and CAT were 23.4%, 10.6%, and 16.9% respectively (p=0.149). The most common causes of application failure were: inadequate tightness (120/203, 59%), improper placement technique (72/203, 35%) and incorrect positioning (27/203, 13%). The speed of application was not associated with successful placement (p=.522). Conclusion: Our pilot study on the ability of laypersons to successfully apply a commercially available tourniquet found unacceptably high rates of failure. Manufacturers must improve their tourniquet’s usability by the lay public before the widespread dissemination of tourniquets will have a significant public health effect.

Subject Area

Public health|Health education

Recommended Citation

Ross, Elliot M, "Stop the Bleed San Antonio: A Public Health Education Project Focused on Hemorrhage Control and the use of Tourniquets" (2017). Texas Medical Center Dissertations (via ProQuest). AAI10272409.