The Origins of Stop the Bleed: From Sandy Hook to a National Movement

In December 2012, twenty children and six staff members were killed at Sandy Hook Elementary School in Newtown, Connecticut. In the months that followed, a small group of trauma surgeons, military medical leaders, federal agency representatives, and law enforcement officials began meeting in Hartford, about an hour east of Newtown, to study a question with operational rather than political weight. Given the realities of how mass casualty events unfold, what could be done to keep more victims alive long enough to reach a hospital?

The group's findings became known as the Hartford Consensus, and they have shaped American emergency response policy ever since.

The Hartford Consensus

The Hartford Consensus convened under the leadership of Dr. Lenworth Jacobs, a trauma surgeon and member of the American College of Surgeons Committee on Trauma. The group included representatives from the FBI, the National Security Council, the Department of Defense, the American College of Emergency Physicians, the National Association of Emergency Medical Technicians, and several major trauma centers. Their work focused on a specific medical reality: most preventable deaths in trauma do not happen on the operating table. They happen in the first few minutes after the injury, before professional responders arrive, and they happen because of uncontrolled bleeding.

A person with a severe arterial wound can bleed to death in two to three minutes. The closest qualified responders, even in dense urban environments, often cannot reach the scene in that window. Whoever is already in the room at the moment of injury, the bystander, becomes the only person positioned to make a difference. The Hartford Consensus articulated a single core principle that has driven every program that followed: no one should die from uncontrolled bleeding when the skills to prevent it can be taught to anyone.

The Consensus was published in four parts between 2013 and 2016. Each iteration sharpened the recommendations and expanded the scope. Hartford Consensus I focused on active shooter events. The Boston Marathon bombing, which occurred just weeks after the first meeting, broadened the focus to all intentional mass casualty events. Subsequent iterations extended the framework to include unintentional trauma, the kind of bleeding emergencies caused by car crashes, industrial accidents, and household injuries that account for the majority of preventable bleeding deaths in the United States each year.

Translating Military Medicine into Civilian Practice

The Hartford Consensus did not invent the underlying medical techniques. The skills it called for, particularly the use of tourniquets and hemostatic dressings, had been refined over more than a decade of combat operations in Iraq and Afghanistan. The U.S. military's experience during those conflicts produced a body of evidence that fundamentally changed how prehospital trauma care is delivered. Tourniquets, which had been disfavored in civilian medicine for most of the twentieth century, were re-embraced after data from combat casualty care showed clear survival benefits when they were applied quickly and correctly.

The Department of Defense's Combat Casualty Care Research Program, working alongside the National Security Council, led the effort to translate that battlefield experience into civilian practice. The technical content of what would become the Stop the Bleed campaign came directly from this work. The campaign's logo and slogan were also developed within the Department of Defense, and the program operates under DoD trademark.

The National Association of Emergency Medical Technicians played a parallel role on the training side. NAEMT had already developed Bleeding Control for the Injured, known as the B-Con course, which became one of the foundational curricula for civilian and law enforcement bleeding control training. NAEMT was recognized at the program's national launch for its role in developing the course that thousands of authorized training centers, including Penn Tactical Solutions, deliver today.

The 2015 White House Launch

In October 2015, the White House launched STOP THE BLEED® Stopthebleedcoalition as a national public awareness campaign. The launch represented a coordinated effort across multiple federal agencies, including the Department of Homeland Security, the Department of Defense, and the National Security Council, working with the American College of Surgeons and other professional organizations. The campaign's goal, articulated in plain terms, was to train enough bystanders that someone in the room would always know what to do.

The American College of Surgeons operates the ACS Stop the Bleed program under license from the Department of Defense. ACS has trained nearly five million people worldwide since the program's launch and has become the largest single provider of bleeding control training globally. Other organizations, including NAEMT, the American Red Cross, and the Stop the Bleed Coalition, deliver the curriculum under their own training frameworks.

State legislatures have followed. As of 2025, at least fourteen states had passed laws requiring bleeding control kits in schools or public spaces, and roughly fifteen more had active legislation under consideration. Pennsylvania has not yet passed comparable legislation, though several school districts and municipalities have adopted public-access bleeding control programs voluntarily.

Stop the Bleed Day and Stop the Bleed Month

National Stop the Bleed Day was first observed in 2018, in the months following the Las Vegas shooting in October 2017. The event was organized by a group of military veterans operating training-focused social media accounts who recognized that the campaign's reach was lagging behind its goals. Within hours of the Las Vegas attack, they launched a coordinated effort to expand public training participation.

As participation grew year over year, the single-day observance proved insufficient to coordinate the activity it generated. The observance expanded into a full month, and May was designated National Stop the Bleed Month. The third Thursday of May, during National EMS Week, is recognized as National Stop the Bleed Day Stop the Bleed, anchoring the campaign within the broader emergency medical services awareness calendar.

Where the Work Stands Now

Stop the Bleed is now in its second decade. The program has trained millions, helped pass legislation in more than a dozen states, and contributed to the increasingly common presence of public-access bleeding control kits in schools, stadiums, transit hubs, and workplaces. The medical premise has held up under scrutiny. Studies of programs in major metropolitan trauma systems have shown that bystander tourniquet use, when it occurs, is associated with improved survival.

The work that remains is the work of access. Training that exists in principle but has not reached a particular community provides no benefit to that community. The communities most exposed to violent injury are often the same communities least likely to have been offered training. Closing that gap is the operational frontier of Stop the Bleed in 2026 and beyond.

Penn Tactical Solutions is an NAEMT and ASHI authorized training center based in Philadelphia. We deliver Stop the Bleed instruction as part of our paid course catalog and as part of our community outreach program, which provides non-certified bleeding control training to underserved communities at no cost. To request a class or learn about our outreach work, visit our community outreach page.

STOP THE BLEED® is a registered trademark of the U.S. Department of Defense.