Skip to main content
Top
Published in: BMC Emergency Medicine 1/2021

Open Access 01-12-2021 | Research

Laypeople perception and interpretation of simulated life-threatening bleeding: a controlled experimental study

Authors: Erik Prytz, Rachel Phillips, Susanna Lönnqvist, Marc Friberg, Carl-Oscar Jonson

Published in: BMC Emergency Medicine | Issue 1/2021

Login to get access

Abstract

Introduction

First aid performed by immediate responders can be the difference between life and death in the case of trauma with massive bleeding. To develop effective training programs to teach bleeding control to laypersons, it is important to be aware of beliefs and misconceptions people hold on bleeding and severity of bleeding situations.

Method

A controlled study was conducted in which 175 American college students viewed 78 video clips of simulated bleeding injuries. The volume of blood present (between 0 and 1900 ml), rate of blood flow, and victim gender were systematically varied within participants. Participants were asked to rate injury severity, indicate the appropriate first aid action, and estimate the amount of time until death for the victim.

Results

Though the Stop the Bleed® campaign recommends training laypeople to treat 165 ml of blood loss as life threatening, participants largely rated this volume of blood loss as minimal, mild, or moderate and estimated that the victim had just under one hour to live. Increased blood loss was associated with increased recommendations to use a tourniquet. However, in the 1900 ml conditions, participants still estimated that victims had around 22 minutes to live and approximately 15% recommended direct pressure as the intervention. Severity ratings and recommendations to use a tourniquet were also higher for the male victim than the female victim.

Conclusions

Injury classification, intervention selection, and time to death-estimations revealed that training interventions should connect classifications of blood loss to appropriate action and focus on perceptions of how much time one has to respond to a bleeding. The study also revealed a gender related bias in terms of injury classification and first aid recommendations. Bleeding control training programs can be designed to address identified biases and misconceptions while building on existing knowledge and commonly used terminology.
Appendix
Available only for authorised users
Literature
3.
go back to reference Boshuizen H PA, Gruber H, Strasser J. Knowledge restructuring through case processing: The key to generalise expertise development theory across domains? Educ Res Rev, 2020, 29. Boshuizen H PA, Gruber H, Strasser J. Knowledge restructuring through case processing: The key to generalise expertise development theory across domains? Educ Res Rev, 2020, 29.
4.
go back to reference Wellman HM, Gelman SA. Cognitive Development: Foundational Theories of Core Domains. Ann Rev Psychol. 1992;43:337–75.CrossRef Wellman HM, Gelman SA. Cognitive Development: Foundational Theories of Core Domains. Ann Rev Psychol. 1992;43:337–75.CrossRef
7.
go back to reference Jacobs LM et al. The Hartford Consensus: A National Survey of the Public Regarding Bleeding Control, Journal of the American College of Surgeons, 2016:222;5:948–955. Jacobs LM et al. The Hartford Consensus: A National Survey of the Public Regarding Bleeding Control, Journal of the American College of Surgeons, 2016:222;5:948–955.
8.
go back to reference Murray CJL, Lopez AD. Mortality by cause for eight regions of the world: global burden of disease study. Lancet. 1997;349:9061,1269–76.PubMed Murray CJL, Lopez AD. Mortality by cause for eight regions of the world: global burden of disease study. Lancet. 1997;349:9061,1269–76.PubMed
9.
go back to reference Murray CJL, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392:10159,1736–88.CrossRef Murray CJL, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392:10159,1736–88.CrossRef
10.
go back to reference Tjardes T, Luecking M. The platinum 5 min in TCCC: analysis of junctional and extremity hemorrhage scenarios with a mathematical model. Mil Med. 2018;183:5–6 e207–e215.CrossRef Tjardes T, Luecking M. The platinum 5 min in TCCC: analysis of junctional and extremity hemorrhage scenarios with a mathematical model. Mil Med. 2018;183:5–6 e207–e215.CrossRef
11.
go back to reference Goolsby C, Jacobs L, Hunt RC, et al. Stop the bleed education consortium: education program content and delivery recommendations. J Trauma Acute Care Surg. 2018;84:1,205–10.CrossRef Goolsby C, Jacobs L, Hunt RC, et al. Stop the bleed education consortium: education program content and delivery recommendations. J Trauma Acute Care Surg. 2018;84:1,205–10.CrossRef
12.
go back to reference McCarty JC, Caterson EJ, Chaudhary MA, et al. Can they stop the bleed? Evaluation of tourniquet application by individuals with varying levels of prior self-reported training. Injury. 2019;50:1,10–5.CrossRef McCarty JC, Caterson EJ, Chaudhary MA, et al. Can they stop the bleed? Evaluation of tourniquet application by individuals with varying levels of prior self-reported training. Injury. 2019;50:1,10–5.CrossRef
14.
go back to reference Goolsby C, Rojas L, Moore K, et al. Layperson Ability and Willingness to Use Hemostatic Dressings: A Randomized, Controlled Trial. Prehospital Emergency Care, 2019,23:6, 795–801. Goolsby C, Rojas L, Moore K, et al. Layperson Ability and Willingness to Use Hemostatic Dressings: A Randomized, Controlled Trial. Prehospital Emergency Care, 2019,23:6, 795–801.
15.
go back to reference Tebruegge M, Misra I, Pantazidou A, et al. Estimating Blood Loss: Comparative Study of the Accuracy of Parents and Health Care Professionals. Pediatrics, 2009, 124;4,e729-e736. Tebruegge M, Misra I, Pantazidou A, et al. Estimating Blood Loss: Comparative Study of the Accuracy of Parents and Health Care Professionals. Pediatrics, 2009, 124;4,e729-e736.
17.
go back to reference Adkins AR, Lee D, Woody DJ, White WA Jr. Accuracy of blood loss estimations among anesthesia providers. AANA J. 2014;82(4):300–6.PubMed Adkins AR, Lee D, Woody DJ, White WA Jr. Accuracy of blood loss estimations among anesthesia providers. AANA J. 2014;82(4):300–6.PubMed
21.
go back to reference Redfors B, Angerås O, Råmunddal T, et al. Trends in gender differences in cardiac care and outcome after acute myocardial infarction in Western Sweden: a report from the Swedish web system for enhancement of evidence-based Care in Heart Disease Evaluated According to recommended therapies (SWEDEHEART). J Am Heart Assoc. 2015;4(7):e001995.CrossRef Redfors B, Angerås O, Råmunddal T, et al. Trends in gender differences in cardiac care and outcome after acute myocardial infarction in Western Sweden: a report from the Swedish web system for enhancement of evidence-based Care in Heart Disease Evaluated According to recommended therapies (SWEDEHEART). J Am Heart Assoc. 2015;4(7):e001995.CrossRef
22.
23.
go back to reference Spotnitz, WD, Zielske, D, Centis, V, et al. The SPOT GRADE, SPINE: June 1, 2018 - Volume 43 - Issue 11 - p E664-E671. Spotnitz, WD, Zielske, D, Centis, V, et al. The SPOT GRADE, SPINE: June 1, 2018 - Volume 43 - Issue 11 - p E664-E671.
27.
go back to reference Pellegrino JL, Charlton N, Goolsby C. “Stop the bleed” education assessment tool (SBEAT): development and validation. Cureus. 2020 Sep 21;12(9). Pellegrino JL, Charlton N, Goolsby C. “Stop the bleed” education assessment tool (SBEAT): development and validation. Cureus. 2020 Sep 21;12(9).
28.
go back to reference Maeder EM, Corbett R. Beyond frequency: Perceived realism and the CSI effect Canadian. J Criminol Crim Justice. 2015;57(1):83–114.CrossRef Maeder EM, Corbett R. Beyond frequency: Perceived realism and the CSI effect Canadian. J Criminol Crim Justice. 2015;57(1):83–114.CrossRef
Metadata
Title
Laypeople perception and interpretation of simulated life-threatening bleeding: a controlled experimental study
Authors
Erik Prytz
Rachel Phillips
Susanna Lönnqvist
Marc Friberg
Carl-Oscar Jonson
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-021-00496-2

Other articles of this Issue 1/2021

BMC Emergency Medicine 1/2021 Go to the issue