To the Editor As leaders of the American College of Surgeons (ACS) Committee on Trauma Stop the Bleed Program, we write to address the article “Effectiveness of the American College of Surgeons Bleeding Control Basic Training Among Laypeople Applying Different Tourniquet Types: A Randomized Clinical Trial” by McCarty et al.1 The ACS Bleeding Control course (BCon) was developed in 2016 to prepare lay responders for bleeding emergencies. This course was based on lessons learned by the US military and adopted the windlass Combat Application Tourniquet as the most widely used device with proven efficacy. The Committee on Tactical Combat Casualty Care evaluates the evidence supporting commercial tourniquets, and we advocate for devices meeting those standards. As of May 2019, the list of approved devices includes 5 windlass and 3 ratcheting types.2 Elastic tourniquets were not recommended.
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Bulger EM, Jacobs L, Stewart RM. Bleeding Control Training for the Lay Public: Keep It Simple. JAMA Surg. 2020;155(2):175–176. doi:10.1001/jamasurg.2019.4700
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