ACS COT Guidance for STOP THE BLEED Course Instructors

Committee on Trauma logo Guidelines for Resuming STOP THE BLEED® Courses during the time of COVID-19

Leaders from the American College of Surgeons (ACS) and the ACS Committee on Trauma (ACS COT) are providing the following suggestions regarding initiation of in-person STOP THE BLEED® Courses when the shelter-in-place rules in your area permit appropriately sized gatherings.

There are no changes to the requirements for course instructors, which can be found here, along with the most current course materials.

The local logistics of resuming in-person courses may require changes to address physical distancing and other safety procedures. Sites should comply with rules and regulations as determined by federal, state, and local authority. The suggestions listed below are for your consideration and must ultimately be used in the context of the local rules and regulations:

 General Considerations

  • Sites should draft a pre-course letter to participants that explains the physical distancing and infection control precautions that will be taken for the course.
  • If routine screening is part of your institutional protocol, participants should be notified that temperatures may be taken upon arrival at the course. Participants should be reminded that if they do not feel well, they should stay home.
  • Participants should be requested to leave if they appear to be ill.
  • Buffet-style food is not recommended; no shared utensils, beverages, etc. Food should be boxed or individually wrapped. Beverages should be individual bottles. Group coffee and tea service is not recommended.
  • Participants should be required to wear masks. Gloves should be worn when handling equipment in the skills stations. Course sites should provide gloves, germicidal wipes, and hand sanitizer for the skill stations. Training sites should follow local protocols for PPE.
  • All individuals, participants, and instructors should adhere to physical distancing guidelines.

Courses should ideally be held in venues large enough to allow for appropriate physical distancing. Sites may use video conferencing to complete the lecture portion of the course (for example, Zoom, Google Meet, Webex, GoToMeeting, etc).

Instructors should address concerns regarding COVID-19 transmission while providing bystander care, noting that the primary route of transmission is respiratory, with no evidence of transmission from blood exposure. Bystanders should be encouraged to wear masks during the pandemic. (Note: Surgical masks are being added to ACS STOP THE BLEED® Kits.)

Skills Stations should be completed in-person.

  • It is recommended that sites follow a student-faculty ratio for skills stations that support physical distancing with adequate instructor interaction.
  • Rooms in which skills stations are held need to be large enough to allow the participants and instructors to maintain appropriate physical distancing.
  • Participants will need to be at a skills station one at a time with adequate physical distancing between instructor and participant. All efforts should be made to maintain the interactive nature of the stations within these limits.


  • All equipment should be cleaned and disinfected according to CDC and/or manufacturer guidelines (see below) before and after each training event.
  • If using materials such as pamphlets or booklets, they should be single-use only and not reused for other participants.
  • Materials used for wound packing must be discarded at the end of each course, and fresh training materials will be required. Materials such as t-shirts and scarfs must be disinfected before and after each course.
  • The ACS COT does not recommend using equipment that cannot be properly disinfected.
  • Manufacturer guidelines for cleaning equipment are:
    • Case—Wash with soap and water and allow to dry.
    • Blue training tourniquets (CAT) —Wash with a mild detergent and water. Allow for proper drying prior to use.
    • Z-Medica Trauma Training Legs
      • For the exterior of legs, use a mix of mild detergent and water to wipe down the exterior areas.
      • The trauma trainer has foam areas that come in contact with packing. The foam areas should be cleaned with an alcohol mix (one ounce isopropyl alcohol mixed with 16 ounces of water). 
      • After cleaning, the legs should be allowed to air dry.


DoD Guidance for STOP THE BLEED Course instruction

With the nation still fighting to stop the spread of COVID-19, social distancing remains an essential method to protect lives and preserve the capacity of our hospitals and medical system. The U.S. Department of Defense (DoD) recommends that hands-on classroom-based STOP THE BLEED® training continue to be suspended until at least June 15. In the meantime, learners may take advantage of the many web-based options for STOP THE BLEED® education.

DoD will reevaluate the situation in early June and make further recommendations at that time. Thank you for your continued support of the STOP THE BLEED® program.