Assessing the effect of “Stop the Bleed” training on external hemorrhage management by the lay first responders in prehospital settings in Kakamega County, Kenya

Abstract

Trauma remains a major public health concern worldwide and contributes substantially to mortality and disability. Globally, an estimated 5–8 million deaths occur annually as a result of traumatic injuries. Among these, uncontrolled hemorrhage is a leading contributor to preventable trauma-related deaths. Early recognition and effective control of bleeding are critical in preventing complications and death following traumatic injury. In many low- and middle-income countries, bystanders and community members often serve as the first individuals to respond to emergencies before professional medical teams arrive. Their level of preparedness and practical skills in hemorrhage control, therefore, plays an important role in patient survival. The objective of this study was to assess the effect of “Stop the Bleed” training on external hemorrhage management by lay first responders in prehospital settings in Kakamega County, Kenya. The study was guided by the Health Belief Model and employed a quantitative approach using a quasi-experimental design. Sub-counties were selected using a census approach, while participants were recruited through simple random sampling. A total of 208 lay first responders participated in the baseline assessment prior to training. Baseline data was collected using structured questionnaires, simulated trauma scenarios, and observation checklists. Data analysis was conducted using SPSS version 28. The findings revealed considerable gaps in hemorrhage control practices among participants. 70.1% of the participants approached accident scenes without first assessing scene safety. Only 40% correctly applied direct pressure to control bleeding. The average time from injury to control of bleeding is approximately 24 minutes. An intervention was carried out by training them on external hemorrhage control skills. After training them on hemorrhage control using the “Stop the Bleed" package, post-training data was collected using similar tools used during the pre-training test. There was marked improvement in their practice. Factorial ANOVA showed post-training skills significantly influenced time to bleeding control (F = 5.18, p = 0.024), while age, education, and their interaction were not significant. The study concludes that although bystanders are often. The first to reach trauma scenes in resource-limited settings, many lack adequate skills in basic hemorrhage control. The “Stop the Bleed” training is effective in improving their skills. Therefore, the ministry of health and other stakeholders should implement the training widely in order to enhance community hemorrhage control during emergency trauma response in the county.