Breaking Down the Recent Bleeding Control Kit Legislation in CA
Assembly Bill 2260 (AB2260), “Emergency Response: Trauma Kits” was passed and signed by Gov. Gavin Newsom in California on Tuesday, September 27, 2022, requiring that trauma bleeding control kits be installed in public and private buildings built on or after January 1, 2023, throughout the state of CA.
The passage of this bill comes as the culmination of six years of movements to pass similar bills and a two-year rewriting process to help AB2260 align more closely with existing AED legislation. Assembly Bill 2260 will hitherto be known and referred to as the Tactical Response to Traumatic Injuries Act (TRTI Act).
How CA Law Defines a Trauma Kit
Under the law, a trauma kit refers to a first aid response kit that contains—at minimum—a tourniquet endorsed by the Committee on Tactical Combat Casualty Care, a bleeding control bandage, a pair of scissors, a pair of nonlatex gloves, a marker, and instructional materials from the Stop the Bleed campaign, the American Red Cross, the American College of Surgeons Committee on Trauma, the Committee for Tactical Emergency Casualty Care, or another U.S. Department of Defense partner.
In addition, the trauma kit supplier should provide all information needed for the use and maintenance of the trauma kit.
Types of Buildings Affected by the New Law
The new law applies to specific types of new-construction properties with specific occupancies.
- Group A (entertainment, worship, or dining) buildings with an occupancy exceeding 300 people.
- Group B (business/office) buildings with an occupancy of at least 200 people.
- Group E (school/educational) buildings with an occupancy of at least 200 people.
- Group F (factory) buildings with an occupancy of at least 200 people.
- Group I (institutional) buildings with an occupancy of at least 200 people. An institutional facility is defined as one where people are unable to leave without assistance, such as a hospital, nursing home, or prison.
- Group M (retail, mercantile) buildings with an occupancy of at least 200 people.
- Group R (residential) buildings with an occupancy of at least 200 people, (excluding single-family and multifamily units).
Under the current terms of AB2260, only buildings constructed on or after January 1, 2023 will be required to heed the new law. However, this may change in the future.
As we’ve seen with similar AED legislation, these bills often focus on new construction in the beginning and are later expanded to include all existing buildings that meet the requirements. So it’s not a bad idea for property owners to get ahead of the legislation and start equipping their own facilities with trauma kits before any additional mandates are introduced.
What the Bleeding Control Kit Legislation Requires
To remain in compliance with the new law, applicable building owners/managers are required to do the following:
- Maintain a minimum of 6 trauma kits on the premises.
- Store all trauma kits in an easily recognizable container beside an automated external defibrillator (AED).
- Inspect each trauma kit every three years from the date of installation and replace any expired parts.
- Quickly replace any trauma kits or trauma kit components that have been used in an emergency, thus ensuring that the required number of components is always available.
- Notify tenants annually of the availability and location of the trauma kits and provide information about where tenants can obtain trauma kit training.
Key Organizations Behind AB2260
The effort to pass AB2260 was led by the San Diego-Imperial, Northern California, and Southern California State Chapters of the American College of Surgeons (ACS).
It was co-sponsored by State Assemblymember Freddie Rodriguez (D-52) and State Senator Ben Hueso (D-40) and backed by a coalition of 11 trauma medical-related organizations, including the California Medical Association, the California Emergency Nurses Association, and the California Society of Anesthesiologists.
The American College of Surgeons is the same organization that developed the STOP THE BLEED® course, launched at a national level in 2015.
Why Bleeding Control Kits Are Essential for Saving Lives
When massive bleeding occurs as the result of a deep cut, gunshot wound, or crush injury to the extremities, death can occur within as little as five minutes if nothing is done to stem the flow of blood.
In the coalition’s letters to Governor Newsom prior to the signing of AB2260, the California State Chapters, COT, and the coalition emphasized that California is especially at risk of severe bleeding injuries because of the state’s tendency to experience natural disasters, including earthquakes.
According to the proponents of AB2260, having a trauma kit on hand gives bystanders the tools they need to keep victims alive until they can be transported to a hospital, reducing deaths from traumatic bleeding. Using the tools provided in each bleeding control kit, bystanders will be able to apply the three life-saving techniques taught in STOP THE BLEED®:
- Apply pressure
- Pack a wound
- Apply a tourniquet
What Does a Trauma Kit Include?
A trauma kit includes basic tools to stem the blood flow in cases of traumatic bleeding. According to the text of AB2260, a “trauma kit” includes:
(1) One tourniquet endorsed by the Committee on Tactical Combat Casualty Care
(2) One bleeding control bandage
(3) One pair of non-latex protective gloves and a marker
(4) One pair of scissors
In addition, the kit can include items recommended by the medical director of the local emergency medical services agency.
How True Rescue and STOP THE BLEED® Kits Measure Up
The bleeding control kits that we offer at True Rescue meet the basic requirements of AB2260 as long as the C-A-T™ or SAM-XT tourniquet is selected—both of these tourniquets are endorsed by the CoTCCC. In addition, our intermediate and premium kits include items that can be helpful in cases of severe bleeding:
- Intermediate kit - two vented chest seals for perforating chest injuries
- Premium kit - two vented chest seals plus hemostatic gauze for accelerated blood clotting
Licensed STOP THE BLEED® kits are also available for purchase. In fact, we offer them in our store. However, as long as the trauma kit meets the requirements of the TRTI Act, any brand of trauma kit can be used.
The Tactical Response to Traumatic Injury Act Sets a Precedent for the Other States
Kenji Inaba, MD, FACS, FRCSC, Chair of the ACS Committee on Trauma STOP THE BLEED® Steering Committee, stated that he hoped to see other states follow California’s lead and make lifesaving bleeding control kits available everywhere.
As in the case of AEDs, which were first legislated in Florida and are now legislated in all 50 states, California’s new trauma kit legislation can serve as a model for other states—potentially saving thousands of lives.
