Medical Reserve Corps Promote and Train Community Active Bystanders

Stop the Bleed and Until Help Arrives campaigns encourage the public across the nation to stand up as active bystanders during an emergency event within their community. Each year, approximately 60,000 victims in the United States die from internal and/or external hemorrhaging. In some cases, it may take only five minutes for blood loss to take a life [1]. Stop the Bleed training provides individuals with the necessary knowledge and tools to assist a hemorrhage emergency until professional help is available [2]. Until Help Arrives training takes a broader stance by outlining five simple steps to take during the crucial early stages of an emergency. By following these steps, active bystanders are better equipped to not only provide immediate aid to bleeding victims, but also position and comfort the injured before first responders arrive [3].

Both initiatives strive to improve community resiliency and empower the public to prepare for and respond to emergencies. In some cases, such as mass casualty events, actions taken by active bystanders are critical as emergency responders may face challenges in accessing the incident site.

The Medical Reserve Corps (MRC) is a national network of local volunteer units who engage their local communities to strengthen public health, reduce vulnerability, build resilience, and improve preparedness, response, and recovery capabilities [4]. To date, there are 860 MRC units with approximately 180,858 volunteers across the nation [5]. These units and volunteers actively work to improve community preparedness by assessing community needs and educating the public. NACCHO has a long history of supporting MRC units through capacity building awards, including project based Challenge Awards that aim to build community public health, resiliency, and preparedness. May 2019 was the first annual National Stop the Bleed Month, during which over 25 MRC units dedicated about 780 hours to Stop the Bleed training [5].

Niagara County MRC Unit #220 Volunteers with Stop the Bleed Materials

MRC Units Taking Action

Defiance County MRC Unit #258 Bleeding Control Kit

We are bolstering resiliency across Niagara County by empowering the general public to make a difference in a life-threatening emergency.

The following MRC unit examples were developed through the 2018 Challenge Awards Program:

The Niagara County MRC Unit #220 in Lockport, New York, in collaboration with Erie County’s Specialized Medical Assistance Response Team (SMART) and other partners, has offered over 75 Stop the Bleed trainings. “We are bolstering resiliency across Niagara County by empowering the general public to make a difference in a life-threatening emergency,” said Director of Public Health Planning and Emergency Preparedness, Elise Pignatora [6]. This initiative has led to the training of over 1,000 people.

In Defiance, Ohio, the Defiance County MRC Unit #258 strategized to place bleeding control kits in areas of high risk for terrorism and areas where events with high participation numbers occur. These kits provide the tools necessary to control hemorrhage until medical help arrives. The goal of this campaign was to increase the educational awareness of the general public regarding hemorrhage control similar to initiatives for CPR and AED application. Along with placing the bleed kits in pre-determined areas and with local businesses, the Defiance County MRC has partnered with Promedica Defiance Regional Hospital and local Emergency Management Agencies to provide Stop the Bleed trainings.

With the idea that active bystanders can and should include community members of all ages, the Green River District MRC Unit #199 in Owensboro, Kentucky, has directed their efforts towards developing and implementing an active bystander curriculum for children. In collaboration with a local elementary school teacher, three curriculums covering grades K-3, 4-6, and 7-8 have been developed utilizing classroom and hands-on activities. Additionally, workbooks and coloring sheets have been created as educational tools for students to take home and share. As the Green River District MRC begins to implement lessons-learned in order to improve the program, next steps include creating classroom kits and "train the trainer"programs so the curriculum can be utilized by other groups.

Pee Dee Public Health Reserve Corps Unit #1125 Volunteer with Stop the Bleed Kit


Shanlynn Bias, MPH, NACCHO Program Analyst

The Pee Dee Public Health Reserve Corps Unit #1125 in Sumter, South Carolina, worked alongside other South Carolina MRC units to assemble training kits for predetermined placement around the state. Twelve training kits and 16 commercially made mannequin legs were distributed as a result of this project. Utilizing the newly available training equipment, 65 new instructors were trained in order to provide Until Help Arrives and Stop the Bleed classes within their community. Due to the availability of these instructors, 1,366 community members have received training with the end-goal of improving community preparedness and resiliency to emergency events resulting in injury.

The tireless work of MRC units like Niagara County, Defiance County, Green River District, and Pee Dee Public Health Reserve Corps helps ensure communities across the nation are better prepared to provide immediate assistance to those in need during medical emergencies. Equipped with the necessary tools and knowledge, community members can step into their role as active bystanders when their fellow neighbors need them the most.


[1] Healthline. “Bleeding to Death: What Does it Feel Like, How Long Does it Take, and Am I at Risk?” 2018. <>

[2] U.S. Department of Homeland Security. “Stop the Bleed.” 2018. <>.

[3] U.S. Department of Homeland Security. “You Are the Help Until Help Arrives.” <>

[4] National Association of County and City Health Officials. “Medical Reserve Corps.” 2019. <>

[5] Assistant Secretary for Preparedness and Response. “Medical Reserve Corps Monthly Report: May 2019.” 2019. <>

[6] Niagara County Department of Health. “Niagara County Promoting Stop the Bleed Training to Empower Bystanders and Save Lives.” 2019. <>