STOP THE BLEED!

STOP UNCONTROLLED BLEEDING COURSE

AN INITIATIVE TO TRAIN LAY-RESCUERS IN BLEEDING CONTROL TECHNIQUES

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ANALYSIS DOCUMENT
Performance Analysis

The Gilbert Public Schools Unified School District (GPSUSD) includes six high schools in
Gilbert and Mesa, Arizona with a total of 604 high school teachers. With recent increases in
gun violence and student shootings in the United States, the GPSUSD decided to join the
Stop the Bleed initiative, a program that empowers bystanders to help in bleeding
emergencies until professional help arrives. A survey was issued to all GPSUSD’s high school
teachers to ask if they knew how to practice effective bleeding control techniques and
whether they would be interested in learning them. Of the total high school teachers in the
district, the survey results showed that 95% said they did not have prior knowledge or
understanding of how to help in the event of a bleeding emergency. The school district
does not mandate teachers know how to stop bleeding in the event of an emergency,
therefore there is a large gap in teachers’ knowledge to do so.

85% of teachers surveyed responded as being interested in learning the techniques.

Interestingly, 94% of high school teachers from Desert Ridge High School indicated interest,
more than any other high school. For this reason, GPSUSD decided to offer its first class on
site at Desert Ridge High School to a test group of 20 teachers (chosen at random from
those who responded as being interested) to reduce the knowledge gap and empower
teachers to practice effective bleeding control techniques with 80% accuracy.

Target Population

The target population for this instructional program is high school teachers at Desert Ridge
High School. Learner characteristics are as follows:
Age
< 29 21%
30-39 27%
40-49 22%
50+ 31%
Gender
Male 46%
Female 54%
Race
White 72%
Black 12%
Hispanic 12%
Other 4%
Highest Education Level
 Bachelor’s - Education 29%
Bachelor’s - Other 15%
Master’s - Education 43%
Master’s - Other 12%
Doctorate - Education 1%
Years of Teaching Experience
1-5 30%
6-9 24%
10-14 16%
15-24 23%
25+ 7%
5% of learners (1 high school teacher) reported having a disability.

95% of the teachers from Desert Ridge High School said they did not have prior knowledge
or experience in bleeding control techniques. 100% claimed to know the definition of a
tourniquet, but 90% said they were not confident in their ability to use a tourniquet. 94% of
the teachers said they were motivated to learn the techniques to become part of the Stop
the Bleed initiative.

Context and Settings

Orienting Context

Since this course is a not a job requirement for the teachers, many see the benefits of
having the course on their resumes, much like having a CPR certification on a resume.
When it comes to having minimum or desired qualifications, those who take this course will
have an edge because the bleeding control certification is uncommon in the high school
teaching community. Additionally, the high school teachers see the course as being
relevant to their jobs in the sense that they ultimately care about their students’ and
colleagues’ safety, especially in the event of an emergency. They see this similar to being
CPR certified, as one cannot predict if/when he or she will become a bystander to a medical
emergency. They will master the bleeding control techniques in a hands-on approach to
demonstrate effective learning and take part in the Stop the Bleed initiative.

Instructional Context

Instruction will take place on site at the high school in the gymnasium, and it will occur
outside of regular school hours to ensure the noise level will be low and adequate for the
program. The lighting is favorable and can be adjusted for brightness, and the temperature
in the gym can also be adjusted. There is a place for the projector to display on the wall
(commonly used during spirit/pep rallies) where the lecture will be displayed. There is an
ample number of available chairs and tables that can be moved to the area near the
projector, and there will be plenty of room for there to be mannequins at each workstation,
a vital piece of the learning materials. If the instructional program is a success for the 20
learners, the gym can easily accommodate a larger number of learners in future classes.

Transfer Context

The high school principal and school board are very much in support of this initiative. If the
instructional program is a success for the participating high school teachers, then the goal is
to provide them with bleeding control kits to place in their classrooms to be able to use
them in their real workspaces in the event of an emergency. A larger goal would be to train
all the high school teachers how to practice effective bleeding control techniques and have
kits in various rooms throughout the school. The principal of the school also plans to use
these pilot teachers as an exemplar of what it means to take part in the initiative and
commit to the district’s overall mission. Data was not presented to teachers as to how this
course would be specifically transferrable to their job positions, but the survey shared
information that stressed the importance and benefits of knowing how to control blood
loss to all community members.

Instructional Goal

Learners will be able to respond to situations regarding uncontrolled external bleeding and
practice effective techniques to stop bleeding.
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TASK ANALYSIS
The following flowchart shows the steps to follow to stop/control bleeding with two tracks: one
to stop bleeding of the extremities and the other to stop bleeding for junctional areas (groin,
neck, armpit, etc.)

Steps to Control Bleeding

Instructional Objectives

At the end of this program, students will meet the following objectives:

1. Given instructional materials, learners will identify uncontrolled bleeding with 80%
accuracy.
2. Given instructional materials, learners will demonstrate proper technique to apply
direct pressure for bleeding control with 80% accuracy.
3. Given instructional materials, learners will demonstrate proper technique for wound
packing with 80% accuracy.
4. Given instructional materials, learners will identify two common challenges/barriers to
proper tourniquet application with 95% accuracy.
5. Given readily available material for instruction, learners will state one potential
construction of an “improvised tourniquet” with 100% accuracy.
6. Given instructional materials, learners will demonstrate proper technique to apply a
tourniquet with 80% accuracy.

Assessment Instruments

Pre-Test

A pre-test will not be included in this instructional program. A survey was conducted
prior to designing the course that determined lack of knowledge and skills was the
biggest reason high school teachers did not know how to practice effective bleeding
control techniques. However, they also all knew what a tourniquet is, and it is
considered one of the most important materials that will be used during instruction.
Therefore, the instructional design team did not feel it was necessary to include a
pre-test to identify what they already knew about bleeding control techniques.

Post-Test

A post-test will be administered in the gymnasium at the students’ workstations via a

paper and pencil handout after all lessons and practice activities have concluded. It
will be a multiple-choice test to act as a check for understanding of what was covered
in the PowerPoint lecture and the demonstrations of the techniques. It will not be
reviewed for a letter grade but will help inform the instructor and instructional design
team gauge the quality of the instructional materials and course.

An observation guide will be given to instructor that will act as an assessment during
instruction, though he or she will not be asked to physically write down observations.
Instead, the instructor will use the observation questions as a guideline when
students are working through the practice activities that require physical actions. The
purpose is to use scaffolding and help students if they struggle with any of the
techniques during the actions instead of being given feedback after they are finished.
In addition to the multiple-choice assessment, the students will then be asked to
complete a paper and pencil survey to give feedback on the course. The questions are
written in statement format with responses being on a rating scale from “Strongly
Disagree” to “Strongly Agree” and a small comment box at the end that allows
students to write in any extra comments about the course.

Instructional Strategies & Activities

Pre-Instructional Activities:
 Motivational Video: Begin with the opening introduction: “Have you ever
been in a situation where you found someone injured? Were you able to
help? Were there other witnesses or helpers around?” Then, share this video
on the projector with the class. After the video ends, conclude with the
following statement: “Uncontrolled external bleeding is the leading cause of
preventable death. With minimal training, community members can be taught
simple interventions to save lives. Today, we will help you learn how to be
included in the Stop the Bleed initiative by learning how to practice effective
bleeding prevention techniques.”
 Objectives: Learners will be informed of each objective immediately before
each lesson takes place.
 Prerequisites: Immediately after watching the motivational video and listening
to the opening introduction, learners will be asked to share personal stories of
being in situations like what was seen in the video. If no personal stories are
shared, they should be asked to explain how they might respond in the
situations and explain how and why. This will help the instructor determine if
there are more experienced learners in the room, though it is already known
from the survey most learners do not have prior knowledge or skills. Finally,
introduce the PowerPoint slides 1-6

Instructional Objective #1

Given instructional materials, learners will identify uncontrolled with 80% accuracy.

Assessment Method & Sample Assessment Item

There will be a post lesson assessment that will include a question about uncontrolled
bleeding.

Sample Assessment Item:

1. Uncontrolled bleeding from the chest and/or abdomen requires:
a. Early recognition
 b. Early activation of 9-1-1
c. Hospital management
d. All of the above

Instructional Methods/Strategies

The instructional methods will include group discussions as well as a lecture/presentation.

Learners will first be asked how they might identify uncontrolled bleeding and how they
should respond, and then the instructor will present the answer to the question in the slides.

Content Presentation

 Content: Present slides 7-23 that introduce how to identify and respond to
uncontrolled bleeding
 Examples: Show a visual example of applying direct pressure in the slides and a
physical demonstration using the mannequins

Learner Participation

 Practice: Learners will discuss how to identify uncontrolled bleeding, what to look for
(i.e. where the bleeding is coming from) and how to respond.
 Feedback: Learners will receive real-time feedback during the practice activity. As they
are asked to discuss the how to identify, look for, and respond to uncontrolled
bleeding, the instructor will be able to provide verbal feedback and gauge whether
students are comprehending the answers and hence meeting the objective.

Instructional Objective #2

Given instructional materials, learners will demonstrate proper technique to apply direct
pressure for bleeding control with 80% accuracy.

Assessment Method & Sample Assessment Item

Learners will be observed during the practice activity to assess their physical performance.
There will also be a question in the post-test that will address direct pressure.

Sample Assessment Item:

1. The rescuer should continue to provide direct pressure until the:
 a. Bleeding appears to be controlled.
b. Ambulance crew assumes care.
c. Wound is completely packed.
d. Patient becomes unresponsive.

Instructional Methods/Strategies

The instructional methods will include a lecture-presentation combination, as well as an

instructor-led demonstration of proper technique for applying direct pressure to a wound.
After a verbal explanation (using presentation slides to assist) and the instructor
demonstration of how to apply direct pressure to the mannequin, learners will be given time
to run through the demonstration.

Content Presentation

 Content: Present procedures for applying direct pressure as indicated in PowerPoint

slides 24-25
 Examples: Show a visual example of applying direct pressure in the slides and a
physical demonstration using the mannequins

Learner Participation

 Practice: After an explanation and demonstration have been provided by the

instructor, the learners will use mannequins to practice the technique of applying
pressure for bleeding control.
 Feedback: Feedback will be provided real-time by the instructor. As students are
practicing the technique on the mannequins, the instructor will walk around the room
to observe. Comments will be provided to the learners as the instructor sees fit (ie.
probing hints to help them work through the technique, correcting them if errors are
made, etc.)

Instructional Objective #3

Given instructional materials, learners will demonstrate proper technique for wound packing
with 80% accuracy.

Assessment Method & Sample Assessment Item

Learners will be observed during the practice activity to assess their physical performance.
There will also be a question in the post-test that will address wound packing material.

Sample Assessment Item:

1. Hemostatic dressings contain a(n):
a. Double thickness gauze
b. Expanding foam
c. Lubricated surface
d. Clot promoting agent

Instructional Methods/Strategies

The instructional methods will include a lecture, as well as an instructor-led demonstration of

proper technique for wound packing. After a verbal explanation (using presentation slides to
assist) and the instructor demonstration, learners will be given time to perform the skill.

Content Presentation

 Content: Description of hemostatic dressings and procedures for applying direct

pressure as indicated in PowerPoint slides 26-28
 Examples: Show a visual example of wound packing in the slides and a physical
demonstration using the mannequins

Learner Participation

 Practice: After an explanation and demonstration have been provided by the

instructor, the learners will use mannequins to practice the technique of wound
packing for bleeding control.
 Feedback: Feedback will be provided in real-time by the instructor. As students are
practicing the technique on the mannequins, the instructor will walk around the room
to observe. Comments will be provided to the learners as the instructor sees fit (ie.
probing hints to help them work through the technique).

Instructional Objective #4

Given instructional materials, learners will identify two common challenges/barriers to

proper tourniquet application with 95% accuracy.

Assessment Method & Sample Assessment Item

Learners will answer a question in the post test about common mistakes/challenges to
applying a tourniquet.

Sample Assessment Item:

1. Which of the following is a challenge or common mistake in tourniquet application?
a. Applying it too loose
b. Loosening it when the injured is in pain
c. Not applying it soon enough
d. All of the above

Instructional Methods/Strategies

The instructional methods will include group discussions as well as a lecture/presentation.

Learners will first be asked what they might consider to be challenges of applying a
tourniquet to a wound, and then the instructor will present a list of common challenges and
mistakes in the presentation. After stating each one, the instructor will ask students to
volunteer to explain why they believe these barriers exist and how they might be able to
overcome them.

Content Presentation

 Content: Present common challenges/barriers to proper tourniquet application from

the PowerPoint slide 32
 Example: A challenge in applying a tourniquet is making sure it isn’t loose

Learner Participation

 Practice: Learners will be asked to restate the barriers or challenges of proper

tourniquet application aloud as a group. The discussion will continue until all barriers
have been recapped. Probing hints may be necessary for learners to recall the
challenges.
o Example Question: What are the challenges we may face with proper
tourniquet application?
 Feedback: Learners will receive real-time feedback during the practice activity. As they
are asked to discuss the reasons why certain barriers to tourniquet application may
exist, the instructor will be able to provide verbal feedback and gauge whether or not
students are comprehending the answers and hence meeting the objective.

Instructional Objective #5
Given readily available material for instruction, learners will state one potential construction
of an “improvised tourniquet” with 100% accuracy.

Assessment Method & Sample Assessment Item

Learners will answer a post-test question about improvised tourniquets.

Sample Assessment Item:

1. Which of the following would NOT be an effective improvised tourniquet:
a. Belt
b. Rope
c. Shirt
d. Necktie

Instructional Methods/Strategies

The instructional methods will include a group discussion as well as a lecture/presentation.

Learners will first be asked what they might consider to be an example of an “improvised
tourniquet”, and the instructor will present a list of examples in the presentation.

Content Presentation

 Content: Present improvised tourniquets slides 33-35 in PowerPoint

 Examples: An example of an improvised tourniquet is a necktie.

Learner Participation

 Practice: Learners will look at the examples that were presented and discuss the
similarities and differences between them. They may discuss other examples they
think are comparable and should be able to explain why the items listed make good
improvised tourniquets.
 Feedback: Learners will receive real-time feedback during the practice activity. As they
are asked to state potential constructions of an “improvised tourniquet” the
instructor will be able to provide verbal feedback and gauge whether students are
providing correct answers and hence meeting the objective. Based on what the
learners guessed, the instructor can reaffirm correct answers and explain why other
guesses may have been incorrect.
Instructional Objective #6

Given instructional materials, learners will demonstrate proper technique to apply a

tourniquet with 80% accuracy.

Assessment Method & Sample Assessment Item

Learners will be observed during the practice activity to assess their physical performance.
There will also be a question in the post-test that will address tourniquet application.

Sample Assessment Item:

1. When bleeding continues after a tourniquet is placed, the rescuer should:
a. Apply a second tourniquet
b. Remove the tourniquet
c. Request the ambulance hurry
d. Recognize the effort is futile

Instructional Methods/Strategies

The instructional methods will include a lecture-presentation combination, as well as an

instructor-led demonstration of proper technique for tourniquet application. After a verbal
explanation (using presentation slides to assist) and the instructor demonstration, learners
will be given time to run through the demonstration.

Content Presentation

 Content: Present procedures for applying a tourniquet as indicated in PowerPoint

slides 28-31
 Example: Physical demonstration using the mannequin of applying a tourniquet

Learner Participation

 Practice: After an explanation and demonstration have been provided by the

instructor, the learners will use mannequins to practice the technique of tourniquet
application.
 Feedback: Feedback will be provided real-time by the instructor. As students are
practicing the technique on the mannequins, the instructor will walk around the room
to observe. Comments will be provided to the learners as the instructor sees fit (ie.
probing hints to help them work through the technique).
STOP THE BLEED!
STOP UNCONTROLLED BLEEDING COURSE

AN INITIATIVE TO TRAIN LAY-RESCUERS IN BLEEDING CONTROL TECHNIQUES

PARTICIPANT BOOKLET
Table of Contents
 Program Introduction……………………………………………………………………………………………………..2
 Content for Each Instructional Objective………………………………………………………………………..3
o Lesson 1………………………………………………………………………………………………………………3
o Lesson 2………………………………………………………………………………………………………………4
o Lesson 3…………………………………………………………………………………………………………..…5
o Lesson 4…………………………………………………………………………………………………………..…6
o Lesson5…………………………………………………………………………………………….…………….….7
o Lesson 6……………………………………………………………………………………………………….…….7
o Post Test and Survey…………………………………………………………………………………………..8
Program Introduction
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Content:

The content follows a White House and Department of Homeland Security initiative to train lay-
rescuers in bleeding control techniques.

Purpose/Goal:

You will be able to respond to situations regarding uncontrolled external bleeding and
practice effective techniques to stop bleeding.

Why This Program Is Important:

Today we live in a world where terrorism, the actions of unstable people, and the dangerous
impulses of friends and relatives are very real and becoming increasingly more frequent.
Massive bleeding from any cause, but particularly from an active shooter or explosive event
where a response is delayed can result in death. Similar to how the general public learns and
performs CPR, the public must learn proper bleeding control techniques, including how to use
their hands, dressings, and tourniquets. Victims can quickly die from uncontrolled bleeding,
within 5 to 10 minutes.
However, anyone at the scene can act as immediate responder and save lives if they know what
to do. BleedingControl.org supports President Barack Obama’s policy directive for national
preparedness (Presidential Policy Directive 8), which targets preparedness as a shared
responsibility of the government, the private and nonprofit sectors, and individual citizens.
BleedingControl.org is an initiative of the American College of Surgeons and the Hartford
Consensus and contains diagrams, news, videos, and other resources contributed by a variety
of other private and nonprofit partners to help prepare you in the event you are witness to one
of these unspeakable events.
Our shared goal is to provide you with a one-stop, online resource to credible information on
bleeding control. We hope you will never need to use this information, but if you do, at least
you will have the assurance that the information is credible and timely.
Above Information Found At: www.bleedingcontrol.org

Objectives:

At the end of this program, you will meet the following objectives:

1. Given instructional materials, identify uncontrolled bleeding with 80% accuracy.

 2. Given instructional materials, demonstrate proper technique to apply direct pressure for
bleeding control with 80% accuracy.
3. Given instructional materials, demonstrate proper technique for wound packing with
80% accuracy.
4. Given instructional materials, identify two common challenges/barriers to proper
tourniquet application with 95% accuracy.
5. Given readily available material for instruction, state one potential construction of an
“improvised tourniquet” with 100% accuracy.
6. Given instructional materials, demonstrate proper technique to apply a tourniquet with
80% accuracy.

Content for Each Instructional Objective

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Lesson 1

Instructional Objective:

Given instructional materials, identify uncontrolled bleeding with 80% accuracy.

Content:

In addition to an introductory video, and slides from the PowerPoint presentation, learners will
cover the following information:

WHY IS THIS TRAINING NECESSARY?

 Bleeding from wounds to the arms and legs is the most frequent cause of preventable
death.
 A victim with rapid, uncontrolled bleeding can die in three minutes.
 Estimated 3 million school-related injuries each year.

WHERE CAN I USE THIS TRAINING?

 Anywhere!

PRIMARY PRINCIPLES OF TRAUMA CARE RESPONSE

■ Ensure your own safety

■ The ABCs of Bleeding
■ A – Alert – call 9-1-1
■ B – Bleeding – find the bleeding injury
■ C – Compress – apply pressure to stop the bleeding by:
 1. Covering the wound with a clean cloth and applying pressure by pushing
directly on it with both hands,
OR
2. Using a tourniquet,
OR
3. Packing (stuffing) the wound with gauze or a clean cloth and then applying
pressure with both hands.

Practice:

Discuss the importance of this training with classmates and instructor. Talk about how you
might respond to uncontrolled bleeding and what to look for with uncontrolled bleeding.

Feedback:

Written knowledge assessment given at the end of the training.

Lesson 2

Instructional Objective:

Given instructional materials, learners will demonstrate proper technique to apply direct
pressure with 80% accuracy.

Content:

You will learn the different steps you can take if you have or do not have a first aid kit when a
victim is bleeding. Demonstrations and practice will be provided on the following information:

If you don’t have a trauma first aid kit:

■ Apply Direct Pressure on the wound. Cover the wound with a clean cloth and apply
pressure by pushing directly on it with both hands.
If you do have a trauma first aid kit: For life-threatening bleeding from an arm or leg when a
tourniquet is NOT available OR for life-threatening bleeding from the neck, shoulder or groin:
■ Pack (stuff) the wound with bleeding control gauze (also called hemostatic gauze),
plain gauze, or a clean cloth and then apply pressure with both hands.
1. Open the clothing over the bleeding wound
2. Wipe away any pooled blood
3. Pack (stuff) the wound with bleeding control gauze (preferred), plain gauze, or
clean cloth.
4. Apply steady pressure with both hands directly on top of the bleeding wound
5. Push down as hard as you can
 6. Hold pressure to stop bleeding. Continue pressure until relieved by medical
responders.
If you do have a trauma first aid kit:
■ For life-threatening bleeding from an arm or leg and a tourniquet is available: Apply
the tourniquet
■ For life-threatening bleeding from an arm or leg and a tourniquet is NOT available OR
for bleeding from the neck, shoulder or groin: Pack (stuff) the wound with a bleeding control
(also called a hemostatic) gauze, plain gauze, or a clean cloth and then apply pressure with both
hands

Practice:

Learners will be able to work on one another on how to properly do the techniques explained
above.

Feedback:

Written knowledge assessment will be given at the end of this lesson.

Lesson 3

Instructional Objective:

Given instructional materials, demonstrate proper technique for wound packing with 80%
accuracy.

Content:

Learners will be given information, along with a demonstration, on the following information:

If you do have a trauma first aid kit: For life-threatening bleeding from an arm or leg and a
tourniquet is available:
■ Apply the tourniquet
1. Wrap the tourniquet around the bleeding arm or leg about 2 to 3 inches above
the bleeding site (be sure NOT to place the tourniquet onto a joint – go above the joint if
necessary).
2. Pull the free end of the tourniquet to make it as tight as possible and secure
the free end--See picture A below.
3. Twist or wind the windlass until bleeding stops--See picture B below.
4.Secure the windlass to keep the tourniquet tight--See picture C below.
5. Note the time the tourniquet was applied--See picture D below.
Practice:

Learners will be able to practice these strategies and proper technique on provided
mannequins.

Feedback:

Written knowledge assessment will be given at the end of this lesson.

Lesson 4

Instructional Objective:

Given instructional materials, learners will identify two common challenges/barriers to proper
tourniquet application with 95% accuracy.

Content:

The content given during this lesson is based on the first three lessons with a focus on the
barriers of using a tourniquet.

Practice:

A guided instruction will take place during this lesson. The discussion will be guided by the
instructor(s) and SMEs to assess your newfound knowledge based on the first three lessons.
Feedback will be provided by instructors and SMEs.
Feedback:

Feedback will be provided by the SMEs and instructors based on the content provided in the
discussions. Proper knowledge and exhibiting this knowledge is crucial in this assessment
process.

Lesson 5

Instructional Objective:

Given readily available material for instruction, learners will state one potential construction of
an “improvised tourniquet” with 100% accuracy.

Content:

Based on the first 4 lessons of this training, learners should have an understanding of how to
identify and apply pressure to a wound. This section will take their newfound knowledge and
evaluate the learner’s ability to assess a situation and act on it.

Practice:

Learners will participate in an “improvised tourniquet” activity where the learners will be given
a situation, and using a mannequin, will demonstrate how to properly use a tourniquet.

Feedback:

Feedback will be given by the SME based on learners’ “improvised tourniquet”.

Lesson 6

Instructional Objective:

Given instructional materials, learners will demonstrate proper technique to apply a tourniquet
with 80% accuracy.

Content:

Much like the “improvised tourniquet” in lesson 5, a similar environment will be provided for
each learner to come into. SMEs should still provide major feedback and instruction during this
assessment with the assistance of the instructor(s).

Practice:
A tourniquet will be provided and learners will demonstrate the proper technique of how to
apply a tourniquet on the mannequin “victim”. SMEs will assess if the learner did it properly,
providing feedback if it was done improperly.

Feedback:

Feedback will be provided after learners properly show techniques for applying a tourniquet on
a mannequin.

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Post Test and Survey

Now that you have successfully covered the materials in this course, it is time to take the post
test. You will be given a handout with multiple-choice questions. The test will be completed
immediately after all practice activities are finished and turned in to the instructor.

After submitting the post test to the instructor, you will be handed a survey to complete before
leaving the classroom area. Please answer all questions honestly and provide any additional
feedback in the comments section.
STOP THE BLEED!
STOP UNCONTROLLED BLEEDING COURSE

AN INITIATIVE TO TRAIN LAY-RESCUERS IN BLEEDING CONTROL TECHNIQUES

INSTRUCTOR GUIDE
Table of Contents

 Part 1: Overview……………………………………………………………………………..…………………….2
o Overview……………………………………………………………………………………………………2
o Instructional Objectives……………………………………………………………………………..2
o Organization………………………………………………………………………………………..…….3
o Materials……………………………………………………………………………………………………3
o Lesson Planning……………………………………………………………………………………..….3
 Part 2: Lesson Sequence………………………………………………………………………………………..4
o Lesson 1……………………………………………………………………………………………….…...4
o Lesson 2………………………………………………………………………………………………….…5
o Lesson 3………………………………………………………………………………………………….…6
o Lesson 4………………………………………………………………………………………………….…7
o Lesson 5………………………………………………………………………………………………….…7
o Lesson 6………………………………………………………………………………………………….…8
o Post Test and Survey……………………………………………………..…………………………..9
Part 1: Overview
--------------------------------------------------------------------------------------------------------------------------------------------------------
Overview

Rationale and General Content

 Using this program requires SMEs and instructors who are familiar with the content
in order to provide a hands-on approach to this training.

Intended Users/Target Learners

 Intended Users: The training program is intended for non-medical emergent care
providers or lay-rescuers. While the program is suited for all community members,
initial training sessions should target those members most likely to encounter
uncontrolled bleeding. The initial audience includes school teachers in a high-risk
environment with no mandatory first aid training.
 Target Learners: High School teachers.

Length of Program

 The program will be 2 hours in length in an in-person class.

 Instructional Goal:
o Goal: Learners will be able to respond to situations regarding uncontrolled
external bleeding and practice effective techniques to stop bleeding.

--------------------------------------------------------------------------------------------------------------------------------------------------------

Instructional Objectives

1. Given instructional materials, learners will state the indication for tourniquet application
with 80% accuracy.
2. Given instructional materials, learners will demonstrate proper technique to apply
direct pressure for bleeding control with 80% accuracy.
3. Given instructional materials, learners will demonstrate proper technique for wound
packing with 80% accuracy.
4. Given instructional materials, learners will identify two common challenges/barriers to
proper tourniquet application with 95% accuracy.
5. Given readily available material for instruction, learners will state one potential
construction of an “improvised tourniquet” with 100% accuracy.
6. Given instructional materials, learners will demonstrate proper technique to apply a
tourniquet with 80% accuracy.
Organization
 Number of Lessons: 6
 Length of Lessons: Varies – See each lesson for length
 Assessments/Tests: (See “Evaluation Plan Organization Chart”)

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Materials and Equipment

 Pencils/pens
 Tables/chairs
 Projector, Computer, and Wifi Connection
 Participant Booklets
 Instructor Manual (this document)
 Post-Test Handouts
 Post-Test Surveys – Instructor and Learner
 PowerPoint Presentation
 Mannequins
 Bleeding Control Kits

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Lesson Planning
 Lesson-by-Lesson:
o Lesson 1: Identifying uncontrolled bleeding
o Lesson 2: Applying direct pressure
o Lesson 3: Wound packing
o Lesson 4: Identifying tourniquet barriers
o Lesson 5: Improvised tourniquets
o Lesson 6: Proper technique for tourniquet application
 Breaking up Lessons:
o Lessons are lecture/demonstration combinations.
 Getting Started:
o Set-up is crucial for each lesson. To ensure each lesson goes well, instructors and
SMEs should have all materials ready to go and all instructions read prior to
training.
 Background Information:
o This training is based on the Stop The Bleed campaign. Training aims to save lives
through proper training and procedures for bleeding control. Visit their website
for additional information, stopthebleed.org.
Part 2: Lesson Sequence
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This section is a lesson-by-lesson description for the instructor.

Lesson 1 (10 Minutes)

Preparation

Objective #1: Given instructional materials, learners will identify uncontrolled bleeding with
80% accuracy.

The instructional methods will include a lecture-presentation combination. There will be an

introductory video and slides from the PowerPoint presentation that make up the content.

Materials

 Pencils/pens
 Tables/chairs
 Projector, Computer, and Wifi Connection
 Participant Booklets
 PowerPoint Presentation
 Mannequins
 Bleeding Control Kits

Procedures

At the beginning of this training, please show learners the STB Lecture PowerPoint. SMEs and
instructors are encouraged to give any additional information based on their own expertise and
experience. Encourage learners to take notes on the presentation as this information will be
used throughout the training.

Next, SMEs and instructors are to introduce the importance of the training, where it’s
applicable, and the ABC’s of trauma care response:

WHY IS THIS TRAINING NECESSARY?

 Bleeding from wounds to the arms and legs is the most frequent cause of preventable
death.
 A victim with rapid, uncontrolled bleeding can die in three minutes.
 Estimated 3 million school-related injuries each year.

WHERE CAN I USE THIS TRAINING?

 Anywhere!
PRIMARY PRINCIPLES OF TRAUMA CARE RESPONSE

■ Ensure your own safety

■ The ABCs of Bleeding
■ A – Alert – call 9-1-1
■ B – Bleeding – find the bleeding injury
■ C – Compress – apply pressure to stop the bleeding by:
1. Covering the wound with a clean cloth and applying pressure by pushing
directly on it with both hands,
OR
2. Using a tourniquet,
OR
3. Packing (stuffing) the wound with gauze or a clean cloth and then applying
pressure with both hands.

Facilitate a discussion amongst students about how they can identify uncontrolled bleeding,
how to respond, and what to look for.

Assessment

Please see the “ASSESSMENT” section for any assessments in this lesson.

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Lesson 2 (20 Minutes)

Preparation

Objective #2: Given instructional materials, learners will demonstrate proper technique for
applying direct pressure with 80% accuracy.

The instructional methods will include a lecture-presentation combination, as well as an

instructor-led demonstration of proper technique for wound packing. After a verbal explanation
(using presentation slides to assist) and the instructor demonstration, learners will be given
time to run through the demonstration.
Materials

 Pencils/pens
 Tables/chairs
 Projector, Computer, and Wifi Connection
 Participant Booklets
 PowerPoint Presentation
 Mannequins
 Bleeding Control Kits
Procedures

SMEs and instructors should start off explaining to learners how to bandage a wound without
having a first aid kit.

If you don’t have a trauma first aid kit:

■ Apply Direct Pressure on the wound Cover the wound with a clean cloth and apply
pressure by pushing directly on it with both hands

If you do have a trauma first aid kit: For life-threatening bleeding from an arm or leg and a
tourniquet is NOT available OR For life-threatening bleeding from the neck, shoulder or groin:
■ Pack (stuff) the wound with bleeding control gauze (also called hemostatic gauze),
plain gauze, or a clean cloth and then apply pressure with both hands.
1. Open the clothing over the bleeding wound
2. Wipe away any pooled blood 3. Pack (stuff) the wound with bleeding control
gauze (preferred), plain gauze, or clean cloth.
4. Apply steady pressure with both hands directly on top of the bleeding wound
5. Push down as hard as you can
6. Hold pressure to stop bleeding. Continue pressure until relieved by medical
responders.

Demonstrate to the learners using either a volunteer or another instructor (if available) to
demonstrate the proper way to bandage the wound.

Next, SMEs and instructors will demonstrate how to properly bandage a wound with a first aid
kit.

If you do have a trauma first aid kit:

■ For life-threatening bleeding from an arm or leg and a tourniquet is available: Apply
the tourniquet
■ For life-threatening bleeding from an arm or leg and a tourniquet is NOT available OR
for bleeding from the neck, shoulder or groin: Pack (stuff) the wound with a bleeding control
(also called a hemostatic) gauze, plain gauze, or a clean cloth and then apply pressure with both
hands

Demonstrate to learners using a volunteer or an available instructor. After you have done this
for both with a first aid kit and without one, provide materials for the learners to practice on
one another. SMEs and instructors should monitor learner progress.
Assessment

Please see the “ASSESSMENT” section for any assessments in this lesson.

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Lesson 3 (20 Minutes)

Preparation

Objective #3: Given instructional materials, learners will demonstrate proper technique for
wound packing with 80% accuracy.
Materials

 Pencils/pens
 Tables/chairs
 Projector, Computer, and Wifi Connection
 Participant Booklets
 PowerPoint Presentation
 Mannequins
 Bleeding Control Kits
Procedures

Be sure that learners understand that a tourniquet is a strap that is placed around the bleeding
area to stop blood flow when a major artery is bleeding. Remind learners that this is a
temporary fix and professional responders or doctors still need to be contacted.

Demonstrate the following:

If you do have a trauma first aid kit: For life-threatening bleeding from an arm or leg and a
tourniquet is available:
■ Apply the tourniquet
1. Wrap the tourniquet around the bleeding arm or leg about 2 to 3 inches above
the bleeding site (be sure NOT to place the tourniquet onto a joint – go above the joint if
necessary).
2. Pull the free end of the tourniquet to make it as tight as possible and secure
the free end--See picture A below.
3. Twist or wind the windlass until bleeding stops--See picture B below.
4.Secure the windlass to keep the tourniquet tight--See picture C below.
5. Note the time the tourniquet was applied--See picture D below.
Note: A tourniquet will cause pain but it is necessary to stop life-threatening bleeding.
Assessment

Please see the “ASSESSMENT” section for any assessments in this lesson.

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Lesson 4 (10 Minutes)

Preparation

Objective #4: Given instructional materials, learners will identify two common
challenges/barriers to proper tourniquet application with 95% accuracy.

The instructional methods will include group discussions as well as a lecture/presentation.

Learners will first be asked what they might consider to be challenges of applying a tourniquet
to a wound, and then the instructor will present a list of barriers in the presentation. After
stating each one, the instructor will ask students to volunteer to explain why they believe these
barriers exist and how they might be able to overcome them.
Materials

 Pencils/pens
 Tables/chairs
 Projector, Computer, and Wifi Connection
 PowerPoint Presentation
 Mannequins
 Bleeding Control Kits
Procedures

Instructors and SMEs will engage the learners in a discussion about how there might be barriers
when using the tourniquet and what they might be. SMEs are encouraged to use their expertise
and experience to share times they needed to use a tourniquet and what the outcome was.

Please note that the learners should be providing majority of the conversation and the
instructors and SMEs who are not leading the discussion should be giving feedback for EACH
learner. SMEs and instructors should correct any misguided information learners may
unknowingly provide.

Note, ALL learners need to speak during the discussion to prove comprehension of the topic.
Assessment

Feedback: Learners will receive real-time feedback during the practice activity. As they are
asked to discuss the reasons why certain barriers to tourniquet application may exist, the
instructor will be able to provide verbal feedback and gauge whether or not students are
comprehending the answers and hence meeting the objective.

Feedback and key is provided in the “ASSESSMENTS” section.

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Lesson 5 (15 Minutes)

Preparation

Objective #5: Given readily available material for instruction, learners will state one potential
construction of an “improvised tourniquet” with 100% accuracy.
Materials

Pencils/pens
Tables/chairs
Projector, Computer, and Wifi Connection
Participant Booklets
PowerPoint Presentation
Mannequins
Bleeding Control Kits
Procedures

Based on the first 4 lessons of this training, learners should have an understanding of how to
identify and apply pressure to a wound. This section will take their newfound knowledge and
assess learners ability to assess a situation and act on it.
Performing the “improvised tourniquets”:

SMEs and instructors are suggested to take learners into a separate room (if available) to
perform these “improvised tourniquets” individually. It is also suggested that the SME provide
the content and overall feedback to this lesson while instructors assist.

SMEs should do the following:

1. Have a learner come into an already set-up room with a mannequin in “distress”
2. Tell the learner the scene (examples below)
a. There is a person with blood spurting out of the wound above the elbow
b. There is a person with blood that won’t stop bleeding out of the wound in the
upper thigh
c. There is a person with blood pouring on the ground from the upper thigh
d. There is a person with clothing soaked in blood in the abdominal area
e. There is a person with a bandage that has soaked through above the knee
f. There is a person who has lost all (or part) an arm (or leg)
g. There is a person bleeding who is confused (or unconscious)
3. Ask the learner what he/she will do (have the learner do this and explain what he/she is
doing as they do)
4. As the learner explains how they are treating the victim, provide context for each
situation (examples below)
a. After you did ___, the victim is still bleeding
b. After you did ___, the victim has become unresponsive
c. After you did ___, the victim’s bleeding has slowed
5. Repeat step 4 as the SME sees fit
6. Provide feedback after each learner has gone through their “improvised tourniquet”
Assessment

Feedback: Learners will receive real-time feedback during the practice activity. As they are
asked to state potential constructions of an “improvised tourniquet” the instructor will be able
to provide verbal feedback and gauge whether or not students are providing correct answers
and hence meeting the objective.

See feedback instructions and key in the “ASSESSMENTS” part of this training.

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Lesson 6 (25 Minutes)

Preparation

Objective #6: Given instructional materials, learners will demonstrate proper technique to
apply a tourniquet with 80% accuracy.
Materials
 Pencils/pens
Tables/chairs
Projector, Computer, and Wifi Connection
Participant Booklets
PowerPoint Presentation
Mannequins
Bleeding Control Kits
Procedures

Much like the “improvised tourniquet” in lesson 5, provide a similar environment for each
student to come into. SMEs should still provide major feedback and instruction during this
assessment with the assistance of the instructor(s).

As the learner enters the room, have a mannequin set up with one of the following examples
provided:
a. There is a person with blood spurting out of the wound above the elbow
b. There is a person with blood that won’t stop bleeding out of the wound in the upper
thigh
c. There is a person with blood pouring on the ground from the upper thigh
d. There is a person with clothing soaked in blood in the abdominal area
e. There is a person with a bandage that has soaked through above the knee
f. There is a person who has lost all (or part) an arm (or leg)
g. There is a person bleeding who is confused (or unconscious)
Have the tourniquet provided and allow learners to demonstrate the proper technique of how
to apply a tourniquet on the mannequin “victim”. SMEs should assess if the learner did it
properly, providing feedback if it was done improperly.

Assessment

Please see the “ASSESSMENT” section for any assessments in this lesson.
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Post Test and Survey (20 Minutes)

Now that learners have successfully covered the materials in this course, it is time to take the
post test. You will give students the assessment handout with multiple-choice questions. The
test will be completed immediately after all practice activities are finished.

As each student turns in his or her assessment, you will hand out the post course survey each
student will complete before leaving the classroom area. After all students have turned in the
surveys and the course has come to a close, you will also fill out a survey based on your feelings
and thoughts about the design of the course. This will be submitted to the instructional design
team.
FORMATIVE EVALUATION PLAN

Evaluation Purpose

The purpose of this formative evaluation is to inform the instructor if the course/workshop is
completely and adequately addressing the objectives and if the learning materials are effective
instruments to deliver the content for the course.

Evaluation Objectives or Evaluation Questions

 Does the content of instruction accurately address each of the stated objectives?
 Do the instructor guide and participant booklet provide a strong, easy-to-follow
framework for instruction to be delivered?
 Are the learning materials effective in helping learners to gain adequate skills to practice
effective bleeding prevention techniques?
 Are the practice activities satisfactory measurements of the objectives for this course?
 Does the assessment adequately test the learners’ abilities to meet all performance
objectives?
 Is the course length appropriate for learning the content?

Evaluation Plan Organization Table

Evaluation Questions Phases of Data Data Collection

Evaluation Source/Participants Instruments

Does the content of Expert review Instructor Survey

instruction accurately
address each of the stated
objectives?

Do the instructor guide and
participant booklet provide
a strong, easy-to-follow
framework for instruction
to be delivered?
Expert review Instructor (expert Surveys (one for
(instructor review), Selected target the instructor and
guide), Field trial learners (field trial) another for the
(participant learners)
booklet)

Are the learning materials Field trial Selected target learners Survey
effective in helping learners
to gain adequate skills to
practice effective bleeding
prevention techniques?
Are the practice activities Field trial Selected target learners Observations
satisfactory measurements
of the objectives for this
course?

Does the assessment Field trial Selected target learners Assessment

adequately test the
learners’ abilities to meet
all performance objectives?

Is the course length Expert review, Instructor (expert Surveys (one for
appropriate for learning field trial review), Selected target the instructor and
the content? learners (field trial) another for the
learners)

Place/Context/Organization

The formative evaluation will take place in the form of surveys, observations, and an
assessment. This will take place in a traditional classroom or conference room that has Wifi
availability and a projector, the same room the course takes place in. Observations will be
made in the classroom by the instructor during each practice activity that requires a hands-on
approach to learning (Objectives 1, 2, and 6). The instructor of the course will take a survey
following the completion of the course, and the learners will take a separate survey at the
completion of the course prior to leaving the classroom. The results of the course’s
assessment will also be included as part of the evaluation. The learner surveys will be
completed with pencil/pen and paper in the classroom and turned in to the instructor. The
instructor survey will be completed with pencil/pen and paper either in the classroom or
elsewhere (ie. his/her office) and turned in to the instructional design team.

Participants/Audiences

The participants of the formative evaluation will include all learners that participate in a
single course (approximately 20 learners) chosen at random. The learners are public school
teachers that signed up for the course. In addition, the instructor of the course will be
considered a participant for the instructor survey.

Procedures/Steps
Field Trial: After all content has been delivered, all practice activities have been completed,
and the assessment has been taken, the instructor will hand out the learner survey to each
learner. The survey should only take 5-10 minutes to complete, and learners are allowed (and
encouraged) to stay past the course end time should they want to provide additional
feedback in the comments section of the survey. Students will answer each question on a
rating scale, from strongly disagree to strongly agree, by checking a single box. They are able
to provide written feedback on their experience taking the course at the bottom of the
survey, which will provide the instructional team with some insight of the learner attitude
and overall feelings about effectiveness of the course.

Expert Review: After the content has been delivered, all practice activities have been
completed, and the assessment has been taken and graded, the instructor will be asked to
take a survey on how effective the course was in meeting identified objectives. It will be
returned the instructional design team to gauge if the instructor was able to effectively teach
the course using the materials provided and if the instructor felt confident in learners’
abilities to meet the objectives.

Instrumentation

OBSERVATION GUIDE
Objectives 2, 3, and 6 require learners to physically demonstrate techniques to help stop
uncontrolled bleeding. Therefore, the instructor will use the observation guide as a loose tool
to assess or gauge learners’ levels of understanding as they perform each task.

Objective 2: Given instructional materials, learners will demonstrate proper technique to

apply direct pressure for bleeding control with 80% accuracy.

 Are the learners applying direct pressure in the correct fashion (with at least 80%
accuracy)?
 How confident do the learners look as they practice the action of applying direct
pressure to the mannequins? Are they looking around the room to see what others
are doing? Are they asking other learners for help?
 Are learners referring to the presentation slides or participant booklet to reread
instructions?
 Is there a need for intervention/instructor assistance with any of the learners?

Objective 3: Given instructional materials, learners will demonstrate proper technique for
wound packing with 80% accuracy.
  Are the learners demonstrating the proper technique for wound packing (with at least
80% accuracy)?
 How confident do the learners look as they practice the action of wound packing? Are
they looking around the room to see what others are doing? Are they asking other
learners for help?
 Are learners referring to the presentation slides or participant booklet to reread
instructions?
 Is there a need for intervention/instructor assistance with any of the learners?

Objective 6: Given instructional materials, learners will demonstrate proper technique to

apply a tourniquet with 80% accuracy.

 Are the learners applying tourniquets to the mannequins in the correct fashion (with
at least 80% accuracy)?
 How confident do the learners look as they practice the action of applying tourniquets
to the mannequins? Are they looking around the room to see what others are doing?
Are they asking other learners for help?
 Are learners referring to the presentation slides or participant booklet to reread
instructions?
 Is there a need for intervention/instructor assistance with any of the learners?

The guideline does not need to be answered in written format. These are physical
observations that will be made as each objective is reached during the course, and help will
be provided on an as-needed basis. The rationale for doing so is that the instructor can use
scaffolding to help those who might need help at different stages of each task.

LEARNER SURVEY
This survey should be taken after review of the participant booklet, content, and all materials
that were used to complete the course. For each of the following questions, check one box.

Statement Strongly Agree Neutral Disagree Strongly

Agree Disagree
Overall, I could meet or perform
the objectives of this course.

Practice Activities
I felt there was enough time to
work through the practice
activities given the participant
booklet and other learning
materials.

The practice activities

complement the content
delivered in the course well.
Overall, the practice activities
are adequate for the course.

Goals and Objectives

The goal and objectives for the
course were clear and concise in
the participant booklet and
content delivered.
There was enough time to
satisfactorily meet all
objectives.

Instructional Materials
The participant booklet
provided a an easy-to-follow
layout of how the course
content was going to be
delivered.
There are adequate learning
materials provided to complete
the practice activities and
assessment.
Overall, the learning materials
helped me to meet the
objectives.

Content
The content was well-developed
and designed for this course.
The presentations contained
accurate information that was
relevant for this course.
 Overall, the content was
appropriate for effective
learning.

Assessment
The assessment was an
accurate measurement my
ability to meet objectives.
The length and design of the
assessment was sufficient for
the course.
Overall, the assessment was
appropriate for this course.

Additional Comments (Optional):

INSTRUCTOR SURVEY
This survey should be taken after review of the instructor guide, content, and all materials that
were used to deliver content for instruction. For each of the following questions, check one
box.

Statement Strongly Agree Neutral Disagree Strongly

Agree Disagree
Overall, the instructional content
satisfactorily meets the stated goal
and objectives for this course.

Practice Activities
I feel there is enough time to work
through the practice activities
given the instructor guide and
learning materials.

The practice activities complement

the content created for instruction
well.
Overall, the practice activities are
adequate for the course.

Goals and Objectives

The goal and objectives for the
course are clear and concise in
both the instructional guide and
participant booklet.
There is enough time to
satisfactorily meet all objectives.
Overall, the goal and objectives
are appropriately defined and met
with the course content.

Instructional Materials
The instructional materials align
with the objectives and purpose of
the course.
The instructor guide and
participant booklet provide a
strong, easy-to-follow layout of
how the course content is to be
delivered.
There are adequate instructional
materials provided to complete
the practice activities and
assessment.
Overall, the instructional materials
adequately address all objectives.

Content
The content is well-developed and
designed for this course.
The presentations contained
accurate information that was
relevant for this course.
Overall, the content is appropriate
for effective instruction.

Assessment
The assessment is an accurate
measurement of learners’ abilities
to meet objectives.
The length and design of the
assessment is sufficient for the
course.
Overall, the assessment is
appropriate for this course.

Additional Comments (Optional):

POST TEST

Name:

1. Which of the following indicate life-threatening bleeding?

a. Blood pooling around the victim.
b. Blood spurting from the victim.
c. Blood saturating the victim’s clothing.
d. All of the above
2. Prior to rendering care, you would:
a. Assess the victim’s pulse
b. Determine the number of victims
c. Ensure the scene is safe
d. Announce your intent to treat the victim
3. C-A-T tourniquets can be applied to uncontrolled bleeding from the .
a. Neck
b. Leg
c. Groin
d. Chest
4. Hemostatic dressings contain a(n):
a. Double thickness gauze
b. Expanding foam
c. Lubricated surface
d. Clot promoting agent
5. When applying a tourniquet, the victim is most likely to experience:
d. Pain
e. Euphoria
f. Hemoptysis
g. Exsanguination
6. When bleeding continues after a tourniquet is placed, the rescuer should .
a. Apply a second tourniquet.
b. Remove the tourniquet.
c. Request the ambulance hurry.
d. Recognize the effort is futile.
7. Which of the following is a challenge or common mistake in tourniquet application?
a. Applying it too loose
b. Loosening it when the injured is in pain
c. Not applying it soon enough
 d. All of the above
8. The rescuer should continue to provide direct pressure until the
a. Bleeding appears to be controlled.
b. Ambulance crew assumes care.
c. Wound is completely packed.
d. Patient becomes unresponsive.
9. ________ is the number one cause of preventable death.
a. Opiate overdose
b. Motor vehicle accidents
c. Uncontrolled bleeding
d. Cigarette smoking
10. Uncontrolled bleeding from the chest and/or abdomen requires:
a. Early recognition
b. Early activation of 9-1-1
c. Hospital management
d. All of the above
11. Which of the following would NOT be an effective improvised tourniquet:
a. Belt
b. Rope
c. Shirt
d. Necktie

POST TEST KEY

Name:
1.Which of the following indicate life-threatening bleeding?
. Blood pooling around the victim.
a. Blood spurting from the victim.
b. Blood saturating the victim’s clothing.
c. All of the above
2.Prior to rendering care, you would:
e. Assess the victim’s pulse
f. Determine the number of victims
g. Ensure the scene is safe
h. Announce your intent to treat the victim
3.C-A-T tourniquets can be applied to uncontrolled bleeding from the .
e. Neck
f. Leg
g. Groin
h. Chest
4.Hemostatic dressings contain a(n):
 e. Double thickness gauze
f. Expanding foam
g. Lubricated surface
h. Clot promoting agent
5.When applying a tourniquet, the victim is most likely to experience:
h. Pain
i. Euphoria
j. Hemoptysis
k. Exsanguination
6.When bleeding continues after a tourniquet is placed, the rescuer should .
e. Apply a second tourniquet.
f. Remove the tourniquet.
g. Request the ambulance hurry.
h. Recognize the effort is futile.
7.Which of the following is a challenge or common mistake in tourniquet application?
e. Applying it too loose
f. Loosening it when the injured is in pain
g. Not applying it soon enough
h. All of the above
8.The rescuer should continue to provide direct pressure until the
e. Bleeding appears to be controlled.
f. Ambulance crew assumes care.
g. Wound is completely packed.
h. Patient becomes unresponsive.
9.________ is the number one cause of preventable death.
e. Opiate overdose
f. Motor vehicle accidents
g. Uncontrolled bleeding
h. Cigarette smoking
10.Uncontrolled bleeding from the chest and/or abdomen requires:
e. Early recognition
f. Early activation of 9-1-1
g. Hospital management
h. All of the above
11.Which of the following would NOT be an effective improvised tourniquet:
e. Belt
f. Rope
g. Shirt
h. Necktie