1 WORKPLACE HEALTH & SAFETY vol. XX ■ no. X PROFESSIONAL PRACTICE Abstract: Background: Uncontrolled bleeding is the leading cause of preventable death from trauma. The Stop the Bleed (STB) initiative provides basic education about bleeding to potential immediate responders. The present study aimed to assess the perceptions of self-efficacy and school preparedness related to responding to a life- threatening bleeding emergency in school personnel at an urban high school. Methods: High school personnel from an urban high school (N = 156) completed a 1-hour STB course that included a didactic and hands-on component. Participants rated their agreement with statements about self- efficacy and school preparedness on a 5-point Likert-type scale, responded to items regarding how school personnel could be better prepared for life-threatening emergencies, and had the option to provide written responses pre- and post-course. Findings: Independent samples t tests revealed that perceptions of self-efficacy and school preparedness increased after the course (p < .001). Before the course, 87% of participants felt they needed training, 80% felt the school needed clearer procedures, and 74% felt the school required more equipment for a life-threatening bleeding incident compared with 63%, 69%, and 78% post-course, respectively. Thematic analysis of written responses revealed that participants desired higher frequencies of STB training, more equipment, clearer school procedures, and realistic training scenarios with students. Conclusions/Application to Practice: The STB course increased both perceptions of self-efficacy and school preparedness in a sample of high school personnel. Qualitative analyses provided insight to personnel’s opinion of STB’s effectiveness and what is necessary to maintain or follow through with this knowledge after completion of the course. Keywords: trauma, hemorrhage control education, tourniquet training, wound packing training, workplace death prevention Background The Centers for Disease Control and Prevention (CDC, 2017a) indicates that homicides are among the top 10 causes of death for individuals 15–24 years of age. In fact, 49,000 homicide deaths were recorded in 2017, making it the third most common cause of death (CDC, 2017b). When homicide is characterized by the specific cause of death, 4,391 homicides were caused by firearms and another 266 are due to cutting or piercing injuries (CDC, 2017b). This is especially concerning when considering the concentrated areas where these injuries are taking place. According to the CDC, of the 12,979 total firearm homicides in 2014, 81% occurred in urban areas (CDC, 2015). Moreover, recent studies using Geographic Information Systems (GIS) have found that violent crimes are not only generally isolated to urban areas, but often negatively impact urban school safety due to their close proximity (Graif et al., 2014; Hermann, 2015; Yang, 2019). Because firearm and cutting/piercing-related injuries are a leading cause of death for those aged 15 to 24 years, and disproportionally impact persons and physical safety of those in urban environments (CDC, 2015), it is reasonable to believe that persons who meet both descriptions, such as high school students attending urban schools, may be at an extreme risk for violent injuries. According to the 2017 Youth Risk Behavior Surveillance Survey, approximately 8.5% of high school students have been in at least one physical fight on school property (Kann et al., 2018). Other studies indicate that the rate of physical altercations is higher in urban school settings, citing that violent communities may give students access to weapons or cultivate poor psychosocial development leading to fights (Bowen & Van Dorn, 2002). As such, when examining only urban areas surveyed, the median percentage of high school students who have been in at least one fight on school grounds is 9.5% (Kann et al., 2018). Furthermore, the number of urban high school 930730WHS XX X 10.1177/2165079920930730WORKPLACE HEALTH & SAFETYWORKPLACE HEALTH & SAFETY research-article 2020 Stop the Bleed The Impact of a Basic Bleeding Control Course on High School Personnel’s Perceptions of Self-Efficacy and School Preparedness Autumn D. Nanassy, MA 1 , Richard L. Graf, MS 2 , Ross Budziszewski, MS 1 , Rochelle Thompson, MS 1 , Adam Zwislewski, BSN RN CCRN PHRN 3 , Loreen Meyer, MSN RN CCRN CPEN 1 , and Harsh Grewal, MD 1,2 DOI:10.1177/2165079920930730. From 1 St. Christopher’s Hospital for Children, 2 Drexel University College of Medicine, and 3 Hahnemann University Hospital. Address correspondence to: Ross Budziszewski, MS, St. Christopher’s Hospital for Children, 160 E. Erie Avenue, Philadelphia, PA 19134, USA; email: ross.budziszewski@towerhealth.org. For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Copyright © 2020 The Author(s)