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Abstract Traumatic injuries remain the leading cause of death for those under the age of 44 years old. Nearly a third of those who die from trauma do so from bleeding. Reducing death from severe bleeding requires training in the recognition and treatment of life‐threatening bleeding, as well as programs to ensure immediate access to bleeding control resources. The Stop the Bleed (STB) initiative seeks to educate and empower people to be immediate responders and provide control of life‐threatening bleeding until emergency medical services arrive. Well‐planned and implemented STB programs will help ensure program effectiveness, minimize variability, and provide long‐term sustainment. Comprehensive STB programs foster consistency, promote access to bleeding control education, contain a framework to guide the acquisition and placement of equipment, and promote the use of these resources at the time of a bleeding emergency. We leveraged the expertise and experience of the Stop the Bleed Education Consortium to create a resource document to help inform and guide STB program developers and implementers on the key areas for consideration when crafting strategy. These areas include (1) equipment selection, (2) logistics and kit placement, (3) educational program accessibility and implementation, and (4) program oversight, facilitation, and administration.

Introduction: Trauma is the leading cause of death for young Americans. Increased school violence, combined with an emphasis on early hemorrhage control, has boosted demand to treat injuries in schools. Meanwhile, coronavirus disease 2019 (COVID-19) has made educating the public about trauma more difficult. A federally funded high school education program in development, called First Aid for Severe Trauma™ (FAST™), will teach students to aid the severely injured. The program will be offered in instructor-led, web-based, and blended formats. We created a program to prepare high school teachers to become FAST instructors via “virtual” in-person (VIP) instruction. We used a webinar followed by VIP skills practice, using supplies shipped to participants’ homes. To our knowledge, no prior studies have evaluated this type of mass, widely distributed, VIP education. Methods: This study is a prospective, single-arm, educational cohort study. We enrolled a convenience sample of all high school teachers attending FAST sessions at the Health Occupations Students of America–Future Health Professionals International Leadership Conference. Half of the participants were randomized to complete the Stop the Bleed Education Assessment Tool (SBEAT) prior to the webinar, and the other completed it afterward; SBEAT is a validated tool to measure learning of bleeding competencies. We then performed 76 VIP video-training sessions from June–August 2020. The FAST instructors assessed each participant’s ability to apply a tourniquet and direct pressure individually, then provided interactive group skills training, and finally re-evaluated each participant’s performance post-training. Results: A total of 190 (96%) participants successfully applied a tourniquet after VIP training, compared to 136 (68%) prior to training (P < 0.001). Participants significantly improved their ability to apply direct pressure: 116 (56%) pre-assessment vs 204 (100%) post-assessment (P < 0.001). The mean score for the SBEAT increased significantly from pre-training to post-training: 2.09 with a standard deviation (SD) of 0.97 to 2.55 post-training with a SD of 0.72 (P < 0.001). Conclusion: This study suggests that a webinar combined with VIP training is effective for teaching tourniquet and direct-pressure application skills, as well as life-threatening bleeding knowledge. VIP education may be useful for creating resuscitative medicine instructors from distributed locations, and to reach learners who cannot attend classroom-based instruction.

Introduction: Laboratory and radiographic studies are often required by psychiatric services priorto admitting emergency patients who are otherwise deemed medically stable. Such testing mayrepresent an unnecessary expense that prolongs emergency department stays without significantlyimproving care. This study determines the prevalence of such testing and how often it leads tochanges in care.Methods: We prospectively tracked laboratory testing among psychiatric patients presenting tothe emergency departments of two academic tertiary care facilities. For each visit we determinedwhether laboratory or radiographic studies were ordered, and whether the examination wasconducted at the request of the emergency physician as part of a medical screening examinationor requested by the psychiatry service. We then determined if this testing changed patientdisposition.Results: Our study enrolled 598 patients. Of these, emergency physicians ordered testing as a partof medical screening on 155 patients (25.9%). We found the psychiatry service ordered laboratoryor radiographic studies for 191 of 434 patients (44.0%) who emergency physicians determineddid not require ancillary testing for medical clearance. Of these 191 patients, only one (0.5%; 95%Confidence Interval: 0.01% - 2.9%) had an abnormal result that led to a change in disposition. TotalMedicare reimbursement rates for the additional ancillary testing in this study was $37,682.Conclusion: Ancillary testing beyond what is required for medical clearance of psychiatricemergency patients rarely alters care. Policies that require panels of testing prior to psychiatricadmission are costly and appear to be unnecessary.