Active bleeding control pilot program in India: Simulation training of the community to stop the bleed and save lives from Road Traffic Injuries

Abstract Introduction Road Traffic Injuries (RTI) are one of the toughest public health challenges confronting India. An estimated 40% of RTI deaths are due to uncontrolled bleeding. Stopping the bleeding in the first few minutes is crucial for meaningful survival considering the delays between the RTI and definitive trauma care. Our objective was to develop and implement a lay first responder Active Bleeding Control (ABC) program to help RTI victims along two high risk corridors using simulation methodology. Methods ABC is a multi-partner collaboration pilot program with government and non-governmental agencies. Therefore, using EMS and Police geolocation data, two corridors of 50 kms of highway with high risk of RTI were identified in Medchal district (population 2.5 million) near Hyderabad city, India. In depth interviews with 22 potential lay first responders were conducted in 2019 to understand the barriers for helping RTI victims. Simulation training modules were developed using a step-by-step scenario script and a 90-min curriculum including a video. A low cost ‘stop the bleed kit' was developed and distributed among volunteers. Data collection to capture use cases, barriers and facilitators to program success is ongoing. Results All 22 respondents reported having witnessed many life-threatening RTI in the area, and had no previous knowledge, training or skills in bleeding control. 1005 ABC volunteers have now been simulation trained to stop the bleed. Of these, 162 have self-reported helping RTI victims on the selected highway corridors. The ABC pilot program shows that by training lay first responders to assess and arrest bleeding, passive RTI "by-standers" can be converted into active "try-standers". Conclusion The ABC program has the potential to create a much-needed community of trained citizens to help save lives from RTI in India.