Systematic review of lay responders educational outcomes to identify life-threatening bleeding

Objective: Identify evidence of how lay responders can accurately identify life-threatening bleeding (LTB) from educational interventions. Method: A systematic review process of the PubMed database to identify experimental and observational studies of educational interventions to identify LTB by lay responders. No exclusion regarding timeframe. Abstracts needed to be in English. Results: Three studies were identified, two with moderate risk of bias due to non-validation of measurement tool and one with a high risk of bias. All studies contributed to a notion that lay responders could identify a gross characteristic of LTB when presented visually. Implications: A gap exists in evidence to suggest lay responders can accurately distinguish LTB from non-LTB in the field or with distractions (e.g., clothing, porous surfaces). A valid means of measuring this learning outcomes would allow for future research to be reviewed and for meta-analysis for educational purposes to distinguish quality within and between programs. Secondarily, it may serve as a proxy for survival behaviors in the field, as application of tourniquets is still rare. Educationally, multiple representations of LTB in a localized context can be used (online or face-to-face) to raise awareness of characteristics of LTB for future identification.