When we work in an emergency department, we are ready for anything and everything. But even without our tools and our toys, our colleagues and resources, we have the skills to deliver basic, lifesaving care at the scene of an accident or emergency. We think the public should be able to help patients in a crisis before they reach the hospital, too. This belief was the genesis for ACEP’s new “Until Help Arrives” citizen first responder training program.

Our desire to bring lifesaving tools to our communities grew from our experience becoming certified hemorrhage control instructors during our trauma rotation in Baltimore. We felt that, with a few simple skills, anyone could be empowered to make a difference when tragedy strikes.

Too often we hear of active shooter events, terrorist attacks, natural disasters, and all manner of medical emergencies in our own communities and throughout the world. Unfortunately, we see many of these victims as patients in our emergency departments. As emergency physicians, we have the closest contact with the EMS system and are often the first physicians who have direct patient contact during these terrible events. Still, sometimes a patient arrives too late for us to save, despite everyone’s best efforts. In some of these cases, basic care delivered by those at the scene of the event could have changed the outcome, saving a life.

An Idea Grows, With Help from ACEP

As we began brainstorming ways to bring these skills to our community, we quickly realized we needed financial support. In our search for funding, we came across the ACEP chapter grant program. This grant program allocates approximately $45,000 annually, of which up to $13,500 may be earmarked for chapter development grants. Created in 1983, the grant program’s goal is “recognizing the important role of ACEP chapters in meeting member needs, educating the public, and furthering the advancement of emergency medicine.” We focused our grant proposal on getting funding to obtain the necessary supplies to share these emergency response skills with our community.

Our grant proposal focused on bringing this training to public places such as schools, community centers, and religious organizations. Historically, these locations have been the targets of devastating terrorist and active shooter events.

Many of these institutions have very little budget set aside for disaster preparedness training and supplies. As part of our proposal, we requested a portion of our funding be allocated to donate a small set of correlated supplies, such as tourniquets and combat gauze, to each location. Not only did we want to provide high-quality training to our community, but we wanted to make a lasting impact by providing some basic bleeding control supplies in case of future emergencies.

Soon after submitting our grant application, we were contacted by ACEP about collaborating with them to pilot their new Until Help Arrives course. Not only would this course teach basic lifesaving hemorrhage control skills, but also compression-only CPR. We were more than excited to be a part of an emergency physician-developed and -driven course intended to provide community members with basic lifesaving skills.

The Course

The Until Help Arrives training is a condensed version of the Federal Emergency Management Agency’s “You Are the Help Until Help Arrives” course. It’s concise and focuses on simple life-saving techniques including how to activate the emergency response system, hemorrhage control, and compression-only CPR. It’s a one-hour course split with a 30-minute lecture presentation and 30 minutes of hands-on skills training.

Most of the development of this course—business logistics, training kit design, and course content—was done by the hard-working staff at ACEP (big shout-out to Rick Murray for his time and contributions). We are grateful for the small role we played providing feedback on course content and equipment development.

We received the first demo training kit in early August 2019, and we immediately went to work teaching the first community classes. We hosted our first course at our own church, motivated by a desire to teach those who handle childcare for the children at the church (including our own). We both have young children who are regularly left in the care of others, so we wanted to provide bleeding control training to those who might care for our families in a disaster. We walked the participants through wound packing, bandaging, tourniquet application, and compression-only CPR. Almost immediately, we had community leaders reaching out to us, requesting we lead more Until Help Arrives courses.

We also presented the course to our fellow EM residents and got an amazing response. Not only did they find the training to be personally beneficial, but there was an overwhelming desire to volunteer their time as course instructors to bring this course to more communities. We all felt like this simple one-hour class could transform our communities by giving individuals the confidence to act during the aftermath of an emergency and potentially save a life.

We want to flood Rhode Island—and eventually our nation—with these Until Help Arrives courses so that more and more people can learn these important, life-saving skills. There is an urgent need and desire for this training, and we have numerous physicians ready and willing to donate their time to lead the courses. Currently we are focusing on not only teaching the course, but also on obtaining more training kits and CPR mannequins to increase the number of community members we can train. To maintain the fidelity and quality of the course, we keep a student-to-instructor ratio at 10:1 or less. The most consistent initial feedback we’ve received from participants is about the confidence they built during the hands-on training portion.

Get Involved Today

Our profession has a deep responsibility to be at the forefront of community education projects, and ACEP’s Until Help Arrives program is a powerful step towards more fully addressing that responsibility. Leading Until Help Arrives courses in your community is a relatively simple way to make a positive impact. ACEP provides the course curriculum and script. Once you go through the process to become a course instructor, available at
www.untilhelparrives.com, you’ll have access to the course curriculum and the instructor portal with helpful resources. ACEP provides a step-by-step process for instructors that provides helpful tips for finding a course, getting attendees, purchasing instructor kits, etc.

ACEP developed this course to help emergency physicians give back to their own communities by equipping citizens with first responder skills. The Until Help Arrives program just launched at ACEP19 in October, and we have a valuable opportunity to help ACEP grow and refine this important initiative during its infancy.

We encourage you all to get involved. Become a course instructor, host local training sessions, and invite local media outlets to help spread the word about the importance of proper emergency response.

Let’s show our communities how much we care. Let’s work together to teach people the skills they need to feel competent instead of helpless. Let’s step outside our emergency departments and use our skills to empower others.

Dr. Wood is a PGY-4 emergency medicine resident and Dr. Bikman is a PGY-3 emergency medicine resident at Kent Hospital in Warwick, Rhode Island.