To the Editor We applaud Goralnick et al1 for their report that a classroom-based “Stop the Bleed” course resulted in roughly half of participants applying a tourniquet correctly 3 to 9 months after training. However, we disagree with the authors’ assertion, “Formal hands-on hemorrhage control training was found to be the most effective method to enable laypersons to control hemorrhage.”1 Their study allocated 103 participants to each of 3 experimental arms and 1 control arm. The experimental arms sought to compare educational effects of flashcards, audio kits, and classroom education with untrained controls.
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Goolsby CA, Kellermann AL, Kirsch TD. Just-in-Time Instructions for Layperson Tourniquet Application. JAMA Surg. Published online January 30, 2019. doi:10.1001/jamasurg.2018.5251
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