California Adopts ‘Stop the Bleed’ Trauma Kit Legislation

As of January 2023, California is the first state in the nation to require that all newly built public and private buildings be equipped with trauma bleeding control kits, thanks to a coordinated legislative effort spearheaded by state chapters of the American College of Surgeons and the Committee on Trauma. While nearly a dozen other states have passed some type of legislation inspired by the ACS Stop the Bleed campaign, most are limited to school settings.To get more news about stop the bleed, you can visit rusuntacmed.com official website.

Every year, over 60,000 Americans and an estimated 2 million people worldwide die from blood loss, with the primary cause being traumatic injuries. “Back in 2018, after the Borderline Bar and Grill shooting in Ventura County, victims that were shot and survived were taken to nearby Los Robles Regional Medical Center, in proximity. Our hospital was also ready to accept patients, but as victims were triaged, many did not make it to us because they died at the scene,” said Thomas Duncan, DO, FACS, the trauma medical director for Ventura County Medical Center and medical co-director for Anacapa Surgical Associates, in Ventura, Calif. “Beyond mass shooting events like these, there are also vehicle crashes, work injuries, earthquakes and many other causes of traumatic injury that can require the public to be the first responders on-site.”

Assembly Bill 2260, “Emergency Response: Trauma Kits,” which was signed into law by Governor Gavin Newsom in September 2022, was modeled after a law passed in 2015 that requires automated external defibrillators (AEDs) to be installed in all buildings with an occupancy of over 200 people.
It’s been a long journey for the legislation, the first version of which was proposed in 2017. “This achievement is a testament to perseverance, to teamwork and to accepting feedback for the prior versions of the bill that failed,” said General Surgery News editorial board member John Maa, MD, a general surgeon at MarinHealth Medical Center, in Greenbrae, Calif., and past president of the Northern California Chapter of the ACS. “In the first iterations of the bill, we worked through a lot of Good Samaritan law and other legal issues, but the perceived costs of equipment, materials and restocking really stalled the legislation.”

Then in 2019, when trauma surgeon Amy Liepert, MD, relocated to California from Wisconsin, where she had been advocating for a trauma kit bill, she began working on grassroots advocacy for Stop the Bleed in partnership with Jay Doucet, MD, the chief of the Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery at UC San Diego Health. Liepert met with state Sen. Ben Hueso (D-Calif.), who, as an assembly member, had led efforts to pass the 2015 AED law—which became a model for bills across the nation—and worked with him to introduce a new version of the original trauma kit bill.

The prior bills were not connected directly to Stop the Bleed, and were much more EMS-led,” explained Liepert, the medical director for acute care surgery at UC San Diego Health. “They included equipment such as chest seals and thermal blankets, which increased the overall cost and are not aligned with the Stop the Bleed program.”

Liepert worked with Hueso to combine language from previous trauma kit bills with the model of Hueso’s AED bill, including an edited list of equipment that matches the Stop the Bleed campaign and strategically headed off future anticipated points of opposition. The final bill specifies that the trauma kits must include a tourniquet endorsed by the Committee on Tactical Combat Casualty Care, a bleeding control bandage, a pair of non-latex protective gloves, a marker, a pair of scissors and instructional materials such as those developed by the Stop the Bleed National Awareness Committee of the ACS or other partners of the Department of Defense.

“We did make a strategic decision not to require bleeding control gauze with impregnated chemicals, just a regular bandage,” Liepert said. “While we agree with [Stop the Bleed] that hemostatic gauzes are superior, the cost factor was important from a legislative standpoint. On the other hand, we did require the tactical tourniquets because we were concerned that people might buy cheap knockoff tourniquets with materials that might not be strong enough or degrade over time. Looking at long-term outcomes and durability, we felt that this was important.”