Stop the Bleed Course Outline


Stop the Bleed (STB) is a DHS sponsored curriculum for treatment of traumatic bleeding by lay providers before trained medical personnel arrive. This is an example outline is for a hands on training session to teach the tools and techniques that lay providers can use to stop massive hemmorage.

Disclaimer: This is not legal or medical advice. Consult licensed providers. If you are experiencing a medical emergency, seek professional care immediately.

Instructions to Students

Students should expect to:

  • be physically active during the course
  • participate in scenarios involving physical contact with others
  • participate in scenarios involving kneeling or laying on the floor
  • wear athletic clothing that is comfortable to move in and will not snag or get caught by velcro


  • PPE
    • Gloves
  • Tourniquet
    • At least one tourniquet per two students
    • CAT style recommended, but customize to model that would be made available to students (e.g. agency issued or company stocked)
  • Chest Seals
    • Can be simulated with plastic sandwich bags and medical tape
    • Petroleum gauze for demonstration, if available
    • Commercial chest seal for demonstration, if available
  • Wound Packing
    • Rolled gauze
    • Hemostatic gauze for demonstration, if available
    • Kerlix for demonstration, if available
    • Wound models
      • Can be a sectioned swimming noodle or yoga block with wound hole
  • Moulage
    • Red duct tape
  • Mylar blanket
  • Improvised Tourniquets
    • A variety of materials can be provided so students can attempt to make an improvised tourniquet

Baseline Exercise

Perform a baseline exercise before instruction in STB course material to gauge students’ current skill level and provide students with a baseline of how they would perform at their existing skill level.

  • Split the students into two groups - rescuers and patients
    • Rescuers should wait outside the room
    • Patients should be arranged around the room and be assigned various traumatic injuries
      • Minor injury examples:
        • Small cut on extremity
        • Shrapnel in eye
        • Finger amputation
        • Disoriented patient
      • Major injury examples:
        • Arm or leg amputation (moulage wrapping extremity)
        • Shrapnel in arm or leg with major bleeding (moulage pool of blood on floor)
        • Penetrating chest trauma
        • Neck wound
        • Gunshot wound to arm, leg, stomach with exit wound on other side
        • Unconscious patient
        • Deceased patient
        • Wounds on back or armpit
    • Stage trauma kits in an area available to rescuers
      • Consider having the trauma kits in another room so they have to be retrieved
      • Consider having less than one trauma kit per rescuer
  • Prompt rescuers
    • There has been an explosion, accident, etc. and several people need help
  • Rescuers respond to the scene
  • Observe the scene
    • Does anyone call 911?
    • How are rescuers assessing patients?
    • Are rescuers obtaining first aid equipment?
    • Are rescuers involving patients in their care?
    • Are rescuers improvising interventions before first aid equipment is available?
    • Do rescuers correctly use available first aid equipment?
  • End the exercise after a few minutes
  • Review with rescuers and patients what went well, what they think they need to learn


Applying STB

  • STB techniques are for treating life threatening bleeding, not minor injuries.
  • Activate EMS or have a bystander activate EMS before assisting patients


  • Scene safety
  • BSI
  • PPE - gloves, glasses
  • Moving patient to safety

Control Bleeding

Without Equipment

  • Apply direct pressure to the wound or to pressure points
  • Can use hands to apply pressure to the wound
  • Can use knee or shin to transect leg or arm
    • Using knee or shin keeps hands free for treating other wounds


  • Discuss when to use a tourniquet
  • Discuss how a tourniquet works
  • Demonstrate parts of tourniquet
  • Demonstrate setup of tourniquet for fast deployment
  • Demonstrate self-application of tourniquet to leg
  • Demonstrate self-application of tourniquet to arm
  • Demonstrate application of tourniquet to patient arm
  • Demonstrate application of tourniquet to patient leg
  • Discuss improvised tourniquet


  • Fully adhere velcro around the limb and tighten until bleeding stops
  • Amputation of arm or leg always requires tourniquet even if it is not currently bleeding as it will likely start bleeding
  • Self application of tourniquet
  • Application of tourniquet to patient arm and leg

Wound Packing

  • Discuss when to use a wound packing
  • Discuss how a wound packing works
  • Demonstrate wound packing


  • Do not use wound packing on the torso
  • Practice packing wound model
  • Practice packing wound model on patient - patient can hold the model on or next to their leg or arm
  • Practice with wet wound model, if available

Airway Improvement

Recovery Position

  • Demonstrate recovery position
  • Check for additional wounds in back and armpits

Respiration Improvement

Chest Seals

  • Discuss when to use chest seals
  • Demonstrate chest seal
  • Practice sealing yoga block wound model, if available



  • Patients with blood loss can experience hypothermia even in comfortable ambient temperature
  • Lower body temperature decreases blood clotting ability
  • Place patient in sunlight, cover with blanket, keep patient off ground
  • Use mylar blanket


  • Use chairs and available equipment to assist
  • Recheck treatments after moving patients


  • No equipment exercise
  • Repeat baseline exercise with a variety of injuries and rotating roles
    • Include a variety of injuries:
      • Minor
      • Extremity major bleed
      • Extremity amputation
      • Chest penetrating trauma
      • Arm/leg penetrating trauma
      • Neck/armpit bleed
    • Scenarios:
      • Car accident
      • Hiking accident
      • Explosion or industrial accident
      • Chainsaw accident
      • Mass casualty incident


  • Activate EMS
  • CARE:
    • Control bleeding
      • Tourniquets for extremity bleeding
      • Wound packing for junctional bleeding
    • Airway improvement
      • Recovery position
    • Respiration improvement
      • Chest seals
    • Exposure
      • Prevent hypothermia
  • Evacuate