Abstract

A severe hemorrhage can result in death within minutes, before professional first responders have time to arrive. Thus, intervention by bystanders, who may lack medical training, may be necessary to save a victim’s life in situations with bleeding injuries. Proper intervention requires that bystanders accurately assess the severity of the injury and respond appropriately. As many bystanders lack tools and training, they are limited in terms of the information they can use in their evaluative process. In hemorrhage situations, visible blood loss may serve as a dominant cue to action. Therefore, understanding how medically untrained bystanders (i.e., laypeople) perceive hemorrhage is important. The purpose of the current study was to investigate the ability of laypeople to visually assess blood loss and to examine factors that may impact accuracy and the classification of injury severity. A total of 125 laypeople watched 78 short videos each of individuals experiencing a hemorrhage. Victim gender, volume of blood lost, and camera perspective were systematically manipulated in the videos. The results revealed that laypeople overestimated small volumes of blood loss (from 50 to 200 ml), and underestimated larger volumes (from 400 to 1900 ml). Larger volumes of blood loss were associated with larger estimation errors. Further, blood loss was underestimated more for female victims than male victims and their hemorrhages were less likely to be classified as life-threatening. These results have implications for training and intervention design.

Highlights

  • Trauma resulting in life-threatening bleeding can occur for a variety of reasons including accidents, assaults, mass casualty events, surgery, childbirth, armed conflict, and intentional selfharm

  • Participants estimated the amount of blood loss and classified the injury as life-threatening or not for 78 5-second video clips

  • The hypotheses that small volumes of blood would be overestimated and large volumes underestimated were supported by the results

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Summary

Introduction

Trauma resulting in life-threatening bleeding can occur for a variety of reasons including accidents, assaults, mass casualty events, surgery, childbirth, armed conflict, and intentional selfharm. Life-threatening bleeding occurs outside of medical facilities and away from trained medical personnel. Visual estimates of blood loss by medical laypeople following competing interests: CJ is a member of the Red Cross; EP and CJ have filed a patent application for a Tourniquet Training Device (application number 20200170649). This does not alter our adherence to PLOS ONE policies on sharing data and materials

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