What We Have Here is a Failure to Tourniquet: Increasing the Efficacy of Hemorrhage Control Training [open pdf - 1MB]
From the thesis Abstract: "Bleeding to death is the primary avertable cause of death for victims who have suffered trauma--like a gunshot wound. Emergency medical services response times of less than five minutes yield the best outcomes for shooting victims, but the average response time is six to eight minutes; help may be even farther away in an ongoing shooting incident or mass shooting event. In emergency incidents, bystanders with some training and some gear--in this case, tourniquets--may provide life-saving aid to victims of traumatic injury until medical personnel can take over. Precedents for involving, equipping, and empowering the public in public safety, including cardiopulmonary resuscitation, automated external defibrillators, and Narcan/Naloxone, have been established. This thesis explores these programs. Several important takeaways from this review can be applied to any immediate responder program. First, priority must be given to providing training in the most widely accessible manner to reach the most people. Second, if specialized equipment is necessary, it must be easy-to-use and readily accessible, and should include instructions. While training is an important first step, building in natural points of contact for trainers and trainees, like requiring recertification, can increase the trainees' retention of and ability to apply those lessons learned."
Naval Postgraduate School, Dudley Knox Library: https://calhoun.nps.edu/