Page 98 - JSOM Winter 2019

protocol was not common in 2017 for personnel who joined ambulance crews, heads of security, and the civilian popula-
rescue associations and public health and nonmedical military tion have also participated in these courses. The University
units. Therefore, in January 2017, a group of volunteers en- of Genova endorsed the program through the SimAv, first
listed in the Volunteer Military Corps of the Italian Red Cross through a national medical students’ association and after
(CMV CRI), an italian military corps auxiliary of the Armed that through a direct collaboration between the local B-Con
Forces, started to provide courses and to teach this protocol. instructors and the SimAv. Since November 2017, 16 B-Con
The aim was to teach and train to the program both civilians courses have been offered, at no cost, to the students within
and military/law enforcement (LE) operators, allowing the university structures. Furthermore, several civilian rescue or-
Stop the Bleed campaign to rise and spread across the country. ganizations cooperated with B-Con instructors in training
ambulance crews, social workers, and nonmedical population.
This approach was possible thanks to the TCCC training
courses that some of these soldiers sustained in United States, The international impact of the Italian Stop the Bleed cam-
at the Cypress Creek EMS rescue association of Houston, paign has occurred both within and outside our national bor-
Texas, in collaboration with the University of Texas, allowing ders (in addition to the activities that took place in military
them to be trained to the bleeding control and to join then the operative areas). During the Emergency Medicine Simulation
Stop the Bleed campaign. An initial CMV CRI staff has thus Seminary (EMSS), which took place at the SimAv in January
been able to acquire the qualification of B-Con Instructors, to 2018, 28 students from several European countries underwent
register in the International ACS B-Con instructors database, B-Con training with military instructors. Because of this ex-
and then to start the first basic training courses. perience, a special training session was then organized in col-
laboration with the Plovdiv Medical University (Bulgaria) and
Teaching Military and LE Personnel the Bulgarian Resuscitation Council, at the end of April 2018,
The activity was initially carried out mainly for personnel en- during which instructors from the University of Genova, also
listed in the Armed Forces and police/LE. enlisted as volunteers in the CMV CRI, trained 120 Bulgarian
students of medicine and nursing.
The first course B-Con, addressed to the volunteer military
personnel of CMV CRI, was held on 23 March 2017. On that Instructors
occasion, the first 14 volunteers were formed by the first group At the beginning of our program, aside the first group of in-
of instructors trained in the United States. Given the positive structors trained in TCCC in the United States, other Instruc-
approach, numerous courses were then delivered across the tors were selected only among the personnel enlisted in CMV
country, always addressed to the personnel of CMV CRI, un- CRI. The requirements were as follows: having attended a reg-
til, on 1 January 2018, the National Inspectorate of the CMV ular B-Con course with proficiency in theoretical and practical
CRI (General Command of Volunteer Health Reserve) as- skills; proposing themselves voluntarily to become an instruc-
signed a mandate for the institution of a coordination group tor; accepting to deliver completely free of charge the training;
for the B-Con program, to coordinate the provision of B-Con and, in particular, satisfying the ACS requirements for being
basic 1.0 training courses for all Italian personnel enlisted in an instructors, also being a physician, registered nurse, EMT,
the military health reserve. or health professional with specific TCCC training. When this
article was written, we had 22 B-Con instructors in the coun-
Following the recognition by the National Inspectorate of try who meet the criteria. For each course provided, we strictly
the CMV CRI of the reliability of the B-Con protocol, formal adhered to an instructor-to-student ratio of 1:8.
requests have been progressively presented by other Italian
Armed Forces and LE to train their operational staff in the Progressively allowing the ACS new professional figures to
procedures of emergency rescue of the B-Con protocol. By the teach the program, we decided to keep, for the military per-
end of 2018, the first official training activities of such person- sonnel, the same condition as above. At this moment, we are
nel were scheduled. planning a specific instructor course, held by a physician and
registered nurses with TCCC training and at least 1 year of
Teaching the Civilian Population experience in teaching B-Con courses.
Instructors of B-Con, enlisted in the CMV CRI, have cooper-
ated in a civilian capacity with numerous rescue associations There are no limitations for civilian candidates who meet the
since the beginning of the activities. In particular, the first ACS requirements to teach B-Con, but because we are not au-
course (21 January 2017) was held in collaboration with a thorized to carry out proper supervision on them, we did not
civil rescue association of the Italian Red Cross, for a mixed consider in our article the courses provided only by civilian in-
group of EMTs and LEs. The first major recognition in the structors, except in the case in which cooperation between mil-
civilian field was recorded in November 2017, thanks to the itary and civilian instructors was required for specific activities.
University of Genova, Faculty of Medicine and Surgery, which
accreditated this activity at the academic level for students of The National Stop the Bleed Day 2018
medicine and nursing. Training courses have been progres- On Saturday 31 March 2018, the National Stop the Bleed
sively delivered according to the B-Con protocol, in which Day 2018 (NSTBD ‘18) took place at an international level.
these students participated in collaboration with the Advanced The event saw its conception at the end of 2017 in the United
Simulation Center of the University of Genova (SimAv), ini- States, when a group of instructors spontaneously gathered to
tially taught by instructors enlisted in the CMV CRI. design a major federal training event, with the aim of attract-
ing more attention to the issue of control and early treatment
The civilians who underwent the B-Con training since Novem- of massive external hemorrhages, emphasizing the possibility
ber 2017 have been for the vast majority medical students, as that such a nefarious event may occur in any context and not
well as students from other medical professions; nevertheless, only in large-scale emergencies. In view of the international
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96 | JSOM Volume 19, Edition 4 / Winter 2019