The Stop-the-Bleed Program, launched by the White House in 2015, seeks to inform, educate, and empower civilians to serve as immediate responders to save lives by control of hemorrhage at the scene of injury. In response to this initiative, the American College of Surgeons Committee on Trauma partnered with the National Association of National Association of Emergency Medical Technicians to develop the Bleeding Control course, which is targeted at the lay public. This course has been widely adopted, with more than 16 000 registered instructors and estimates of 100 000 to 150 000 citizens trained in the first year.¹ Understanding the optimal educational approach to maximize mastery and retention of these skills is critical as we continue to promote and evolve this program. We therefore applaud Goralnick et al² for this excellent assessment of 3 training options for the skill of tourniquet placement. This is a well-designed randomized clinical trial with appropriate statistical analyses. The results overwhelmingly favor in-person training with the bleeding control course vs point-of-care instructions, either visual or audio. The educational level of the training cohorts does not reflect the country because 2017 US census data suggest 38% of adults have high school or less as their highest level of education, compared with only 21.7% in this study.³ However, education level was not associated with skill retention in this study.

由白宫于2015年发起的“止血计划”旨在为平民提供信息，教育和授权，使其能够立即成为应急人员，通过在受伤现场控制出血来挽救生命。为了响应这一倡议，美国外伤学院外科委员会与美国国家紧急医疗技术人员协会联合会共同开发了针对非专业人士的出血控制课程。该课程已被广泛采用，第一年培训了16,000多名注册讲师，估计有10万至15万名公民接受了培训。¹随着我们继续推动和发展该计划，了解最佳教育方法以最大限度地掌握和保留这些技能至关重要。因此，我们对Goralnick等人表示赞赏这项对^2种对止血带放置技能的培训选择的出色评估获得2分。这是一项经过精心设计的随机临床试验，并进行了适当的统计分析。结果绝对比不使用现场或视听指导的出血控制过程更有利于现场培训。培训队列的教育水平并未反映该国家/地区，因为2017年美国人口普查数据显示，有38％的成年人以高中或以下为最高教育水平，而本研究中只有21.7％。³然而，在这项研究中，教育水平与技能保留没有关系。