INTRODUCTION: The American College of Surgeons' Stop the Bleed program has trained more than 1 million individuals to recognize and treat external hemorrhage. Central to this training is tourniquet application. No published studies review the retention of this skill after initial class participation. METHODS: One hundred fourteen volunteers agreed to participate. A random sample of 57 was selected and 46 participated. Upon return 6 months later, each participant demonstrated tourniquet application. An observer compared the application process with steps on a checklist. Each step completed correctly was tallied, and the total score for all 10 steps was computed as a percentage correct between 0% and 100%. RESULTS: The baseline score on the tourniquet skill test was 100% following initial training. At 6 months, mean scores were lower, 69% (SD = 31%) (χ2 = 52.09, df = 1, P < 0.001). Fourteen volunteers (30%) attained a score of 100%, and 28 volunteers (61%) achieved a passing score. Bleeding was stopped or reduced to non-life-threatening levels by 34 participants (74%). Participants with passing scores were more likely to stop or reduce the bleeding than those with failing scores (97% vs 35%; χ2 = 20.99, df = 1, P < 0.001). Of the 17 volunteers who failed, 18% stopped the bleeding, 18% slowed bleeding to a non-life-threatening level, and 64% were unable to control bleeding. DISCUSSION: At 6 months, 39% of participants were unable to successfully apply a tourniquet, and 26% were unable to control life-threatening bleeding. This study demonstrates that refresher training is needed within 6 months of initial training.
INTRODUCTION: The American College of Surgeons' Stop the Bleed program has trained more than 1 million individuals to recognize and treat external hemorrhage. Central to this training is tourniquet application. No published studies review the retention of this skill after initial class participation. METHODS: One hundred fourteen volunteers agreed to participate. A random sample of 57 was selected and 46 participated. Upon return 6 months later, each participant demonstrated tourniquet application. An observer compared the application process with steps on a checklist. Each step completed correctly was tallied, and the total score for all 10 steps was computed as a percentage correct between 0% and 100%. RESULTS: The baseline score on the tourniquet skill test was 100% following initial training. At 6 months, mean scores were lower, 69% (SD = 31%) (χ2 = 52.09, df = 1, P < 0.001). Fourteen volunteers (30%) attained a score of 100%, and 28 volunteers (61%) achieved a passing score. Bleeding was stopped or reduced to non-life-threatening levels by 34 participants (74%). Participants with passing scores were more likely to stop or reduce the bleeding than those with failing scores (97% vs 35%; χ2 = 20.99, df = 1, P < 0.001). Of the 17 volunteers who failed, 18% stopped the bleeding, 18% slowed bleeding to a non-life-threatening level, and 64% were unable to control bleeding. DISCUSSION: At 6 months, 39% of participants were unable to successfully apply a tourniquet, and 26% were unable to control life-threatening bleeding. This study demonstrates that refresher training is needed within 6 months of initial training.