Severe bleeding from traumatic injuries during disasters or accidents can lead to death in as little as five minutes. People can save lives if they act fast to stop the bleeding until medical help arrives. Now, with new training, high-school-age children will also know exactly what to do in an emergency.
The Department of Homeland Security (DHS) Science and Technology Directorate (S&T) and the Federal Emergency Management Agency (FEMA) awarded $2.3 million over a three year period to the Uniformed Services University's (USU) National Center for Disaster Medicine and Public Health (NCDMPH) to develop lifesaving trauma training for high-school-age students last year. The training, called First Aid for Severe Trauma (FAST), offers students no-cost guidance on how to treat traumatic injuries and control severe bleeding until first responders arrive on the scene.
FAST has the potential to save countless lives by empowering our high-school-age students with critical first aid knowledge for life, so they can care for those in distress until help arrives."
William N. Bryan, Senior Official Performing the Duties of the Under Secretary for Science and Technology
S&T created a competitive grant process and last year selected NCDMPH. S&T and FEMA provided guidance to NCDMPH and its project partners, the American Red Cross and HOSA-Future Health Professionals, to develop a training curriculum, outreach strategies and plans to implement FAST nationwide.
FAST evolved from the nationwide Stop the Bleed campaign and incorporates age-appropriate content applicable for high school students. The campaign brings lessons learned from the long U.S. military experience in Iraq and Afghanistan where the swift application of tourniquets, often by non-medically trained soldiers, saved 1,000-2,000 American lives.
"When I was an Air Force officer working in the emergency department in Iraq, I was amazed that some patients survived devastating injuries and made it to us alive," said the FAST Principal Investigator Dr. Craig Goolsby, an Associate Professor and Science Director at NCDMPH. "Sometimes, they survived because their fellow soldiers performed simple, lifesaving actions, such as direct pressure on wounds and applying tourniquets, before medical people could even get to them."
The FAST training courses translate those battlefield lessons to the public and expands on effective communication in a crisis.
Concept of the FAST training program
The FAST curriculum will provide research-based guidance to teach students key actions to help severely injured people, including how to stop uncontrolled bleeding using not only tourniquets, but also direct pressure. The curriculum is customized for high-school-age children based on their educational level in biology and health classes, as well as their psychological development.
"We're working to deploy a curriculum addressing all types of hazards such as school or sport injuries, car accidents, and more," said Ron Langhelm, S&T FAST Project Manager.
Goolsby and a team of experts, including high school teachers and medical experts, developed the training curriculum, which will have three different approaches. The first approach is traditional, involving a teacher in a classroom. The second one is blended, where part of the course is web-based, and part is hands-on practice in a classroom with an instructor. The third type is web-only instruction.
"With these three types of learning, we allow schools to choose the best one to meet their learners' needs and practical considerations, such as time in their curriculum and classroom availability," said Goolsby.
According to a study led by Goolsby, brief web-based training helped 75% of laypeople to apply a tourniquet properly.
Including students in the process
As part of the development of the curriculum, NCDMPH performed educational research at the HOSA International Leadership Conference in Orlando, Florida in June 2019. About 250 students from 39 states took part in the study. The researchers prepared different materials for the three types of teaching approaches. Then they did a series of skills and knowledge tests to see how well the students performed.
"The good news is that we were able to show that students can learn in all of those ways," Goolsby said.
The results from the study, which will come out soon, will be beneficial to schools wanting to adopt the program to find out how well students learn according to the teaching approach the school chooses.
"The students were overwhelmingly excited, and the teachers were very interested in the FAST program," Goolsby said. "Students thought … learning to stop bleeding was important for them to learn."
After the June study, Goolsby's team updated the draft curriculum and the text narrative for a future high school level video.
Throughout the development process, NCDMPH and the American Red Cross are demonstrating aspects of the curricula to students across the U.S. and using the feedback and data to improve the educational materials. As an example of this pilot testing, Goolsby and his team and representatives from Red Cross met in September with students in Philadelphia, PA.
"This was the first time that we went to students and showed them a complete draft version of our new curriculum," Goolsby said. "We received input from the students on everything: the video script, hands-on practice sessions, final exam, and the intensity level and relatability of the course."
S&T, NCDMPH, and the American Red Cross anticipate full courses will be implemented at the beginning of 2021. The program, which will be offered at no cost to schools and will not depend on federal money after completion, will become an American Red Cross program.
"When the project ends, S&T's goal is to ensure this training is available indefinitely, with the ultimate goal to train all high school students across the U.S." said Langhelm. "We want to teach a valuable life skill, something that may save the lives of their friends, families, and potentially strangers. It is better to be able to do something than nothing."