Prioritization of victims with traumatic bleeding among medical laypeople – An experimental study

Immediate responders, or medical laypeople, are believed to be a useful resource in trauma response. However, efficiently providing first aid interventions such as bleeding control, in scenarios with multiple casualties require prioritization among several injured victims. This study aims to explore how medical laypeople prioritize among victims in forced choice scenarios. A controlled online experiment was conducted where participants were presented with 276 image pairs of victims with simulated injuries. The amount of blood loss (100ml, 500ml, 900ml), gender (man, woman), skin color (light, dark), facial expression (unconscious, in pain) and wound visibility (visible, covered) was manipulated across the image stimuli. 429 participants completed the experiment. The findings show that victims with greater blood loss are more likely to be prioritized than victims with lower blood loss. Response time indicates that blood loss is likely to be a major factor while prioritizing victims. Victim gender, skin color, facial expression and wound visibility all significantly affect prioritization to some extent. This study shows that apparent prioritization biases are to be expected in the prehospital setting during medical emergencies for medical laypeople. Such biases could be mitigated through training and education.