Newswise — WASHINGTON, D.C. (March 29, 2024): The American College of Surgeons (ACS) applauds the Washington State Legislature for enacting Senate Bill 5790, which mandates that schools in the state of Washington maintain and provide bleeding control equipment on campus and includes other measures to greatly help communities respond to bleeding emergencies. The bill was signed into law today by Governor Jay Inslee (D).

“The passing of this bill marks the first time we have bleeding control legislation in the state of Washington,” said Bryce R.H. Robinson, MD, MS, FACS, FCCM, Chief of the Region 10 Committee on Trauma (COT) of the ACS and associate medical director of critical care at Harborview Medical Center in Seattle, Washington, who helped lobby for the effort with several other COT members. “It was a multidisciplinary effort to get this legislation across the finish line. In the end, we now have a meaningful bill to help prevent deaths from uncontrolled bleeding for our students and our teachers throughout the state.”

The signing of the bill is the result of years of collaboration and advocacy efforts from multiple groups and organizations across the state, including members of the ACS COT, the ACS Washington State Chapter, the Washington State COT Chapter, emergency medicine personnel and nurses, the University of Washington, as well as the testimony of students and educators in school districts across the state. In signing the law, the state of Washington joins 13 other states that have enacted similar bills to increase access to life-saving education and tools that can help people recognize and respond to bleeding emergencies.

Uncontrolled bleeding from trauma is a major cause of preventable death for people of all ages across the country, including in the state of Washington. Someone with a severe bleeding injury can bleed to death within minutes without proper intervention. Using customized training materials developed with input from trauma surgeons as well as multiple emergency medicine specialties, the ACS STOP THE BLEED® program teaches the public how to recognize a severe bleeding injury and follow three simple steps after calling 911: apply pressure with hands, pack the wound with gauze or clothing, and/or apply a tourniquet.

“Bystanders can help save lives with simple techniques. Having these kits available and having staff trained in using them can make all the difference,” said Sen. Manka Dhingra (D-Redmond), the bill’s sponsor. “Every year, I sponsor legislation brought to me by students in my district. This bill was first proposed by students from Eastlake High School in Sammamish. All Washingtonians, regardless of age, are able to participate in our democracy and shape the laws of our state. Having both students and surgeons as advocates on this bill was truly inspirational — and highly effective.”

How SB 5790 Will Help Save Lives

Introduced by Senator Dhingra, SB 5790 mandates that schools in the state of Washington, beginning in the 2026-27 school year, maintain easily accessible bleeding control equipment on each school campus for use in case of traumatic injuries involving blood loss. Schools must also ensure that a minimum of two employees are trained in bleeding control, with larger schools requiring additional trained employees based on student population (1 for every additional 500). Additional provisions of the bill require annual inspections of the inventory of bleeding control equipment and storing specific items such as tourniquets, compression bandages, gloves, markers, scissors, and instructional documents on blood loss prevention methods.

Surgeons with the COT emphasized that knowing bleeding control techniques is important for everyone no matter where they live, but specific to the state of Washington, the legislation paves the way for students to gain life-saving knowledge early in life, and knowing bleeding control techniques is especially useful for people living rural communities that may lack quick access to trauma care. They also pointed to research demonstrating the value of tourniquet use and the STOP THE BLEED® program, which is based on decades of knowledge gained from advances in military and emergency medicine.1-3

“This legislation represents an important step forward for the state of Washington recognizing that trauma is a leading cause of death of children and young adults across the state,” said Eileen M. Bulger, MD, FACS, Medical Director of ACS Trauma Programs and chief of surgery at Harborview Medical Center, Seattle. “Bleeding emergencies are often unexpected and can happen at any time, and they can certainly happen at school. Having the right equipment at a school and having staff that are prepared and trained to control external bleeding is a significant step forward. With this legislation, every school district will be engaged, which means that every community will be engaged.”

“Accidents and injuries that cause uncontrolled bleeding are a public health crisis,” added Quinton Hatch, MD, FACS, LTC, Vice-Chair of the Washington State COT Chapter and program director of the general surgery residency program at Madigan Army Medical Center in Joint Base Lewis-McChord, Washington. “This bill is a huge step in the right direction toward correcting that problem. Teaching these basic skills at the earliest possible time can hopefully save lives going forward.”

“Surgeon members of our Washington Chapter enthusiastically supported this important legislation with letters and calls to our legislators asking them to pass STOP THE BLEED®,” said Judy Chen, MD, FACS, President of the Washington State Chapter of ACS. “The success of this effort shows how we can all come together to work on legislation that benefits our patients and our communities.”

Other sponsors of this bill include Senator Lisa Wellman (D), Senator Patty Kuderer (D), Senator T’wina Nobles (D), Senator Yasmin Trudeau (D), Senator Sam Hunt (D), Senator Phil Fortunato (R), Senator Bob Hasegawa (D), Senator John Lovick (D), Senator Rebecca Saldaña (D), Senator Derek Standford (D), Senator Javier Valdez (D), Senatore Kevin Van Wege (D), and Senator Claire Wilson (D).

“The American College of Surgeons applauds the hard work of our Trauma leaders in Washington as well as the ACS’s Washington State Chapter member surgeons who worked tirelessly and collaboratively to advocate for this legislation,” said ACS Executive Director and CEO Patricia L. Turner, MD, MBA, FACS. “Legislation such as SB 5790 increases access to life-saving education that empowers the public to recognize and respond to bleeding emergencies when appropriate and safe to do so.”


  1. Barnard LM, Guan S, Zarmer L, Mills B, Blackwood J, Bulger E, Yang BY, Johnston P, Vavilala MS, Sayre MR, Rea TD. Prehospital tourniquet use: An evaluation of community application and outcome. Journal of Trauma and Acute Care Surgery. 2021 Jun 1;90(6):1040-7.
  2. Henry R, Matsushima K, Ghafil C, Henry RN, Theeuwen H, Golden AC, Abramson TM, Inaba K. Increased use of prehospital tourniquet and patient survival: Los Angeles countywide study. Journal of the American College of Surgeons. 2021 Aug 1;233(2):233-9.
  3. Bonk C, Weston BW, Davis C, Barron A, McCarty O, Hargarten S. Saving lives with tourniquets: a review of penetrating injury medical examiner cases. Prehospital Emergency Care. 2020 Jul 3;24(4):494-9.

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Officially launched by the White House in 2015, STOP THE BLEED® is a campaign developed by the Department of Defense to educate the public on life-saving bleeding control techniques following everyday emergencies. The American College of Surgeons (ACS) operates its STOP THE BLEED® program under a licensing agreement granted by the Department of Defense. Using customized training materials developed with input from trauma surgeons as well as multiple emergency medicine specialties, the ACS STOP THE BLEED® program teaches the public how to recognize and respond to a bleeding emergency using three simple steps. Since the program’s inception, more than 3.6 million individuals have been trained under the ACS STOP THE BLEED® program. More information is available at:

About the American College of Surgeons  
The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 90,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.  

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