How to stop bleeding in an emergency until help arrives

Severe bleeding is not something to ignore; It is an emergency. External bleeding is the leading cause of preventable death before people get to the hospital, according to The Hartford Consensus, a committee led by U.S. government agencies and physicians to increase survivability against active shooters and to events resulting in numerous victims.

A mass shooting is a gruesome way to suddenly encounter life-threatening bleeding, but more often than not it can happen in your home or on your commute.

“Bleeding is the number one preventable thing that kills people after injury,” said Dr. Kenji Inaba, trauma surgeon at University of Southern California, Keck Hospital and chair of the National Stop Program Education Committee. the Bleed. “You can drive down the highway to get to work and there can be a traffic accident right in front of you. It can happen in someone’s garage while working on a woodworking project. It can happen in the kitchen when you are cooking dinner. It’s something that can really happen anywhere.

Although you may not be an official first responder, anyone can provide vital assistance. In mass casualty events, 80% of victims are brought to hospital by members of the public.

After calling 911, identifying the source of your own or someone else’s bleeding and stopping that flow of blood can mean the difference between life and death. Once you recognize that the bleeding is serious, you may only have a few minutes to intervene.

“Every second counts. The sooner we can start an intervention to stop this bleeding, the more life we ​​can save once the patient arrives at the hospital,” Inaba said. Here’s how it’s done:

1. Dial 911 and be specific.

Before you start treating the bleed in most cases you should call 911 for help. This way, it won’t be entirely up to you to provide first aid.

As a general rule, Inaba recommends calling 911 as soon as possible, but he noted that exceptions exist.

“There will be situations where, for example, you walk away from the possibility of calling 911. So in a situation like that, we would recommend that someone take vital bleeding control measures before you go. go out 10 minutes to make that 911. call.”

If you can, be more specific than “Help, I have an emergency!” in your call, and give an exact address, said Kyle Bates, paramedic program director at the University of Maryland, Baltimore County.

“People panic and don’t know where they are. “I’m at Walmart.” Great, which one?” Bates said. “I was in an ambulance looking and looking for the person I needed to take care of.”

2. Identify where the bleeding is occurring and determine if it is life threatening.

There’s a difference between a minor injury and a life-threatening situation that you need to address as soon as possible. If the bleeding you see is continuous, profuse, or squirts like “a sprinkler,” it’s life-threatening, according to Stop the Bleed, which is run by the American College of Surgeons Committee on Trauma.

If you’re wondering how much blood bleeds too much, try the soda can volume measurement. If you see the equivalent of half a soda can of blood on the bleeding person, it’s life-threatening, according to an instructional video.

Clothing can hide pools of blood, so be sure to check underneath as well.

“Always check for multiple sources of bleeding,” especially before putting on a tourniquet, Inaba said. “Even the feeling of wetness under clothing can be a very quick check.”

Inaba proposed a scenario where someone notices a calf injury but does not see an injury between the knee and the groin that is hidden by clothing. In that case, he said, putting a tourniquet below the knee could make matters worse.

3. Apply direct pressure to the wound.

Once you spot heavy bleeding, treat it by applying direct pressure to the wound.

“The amount of pressure needed is all it takes to stop this bleeding,” Inaba said. “In the vast majority of cases, applying pressure can successfully stop this bleeding.”

Ideally, you’ll have nitrile or vinyl gloves to protect against bloodborne pathogens, Bates said. But if you don’t have gloves handy, find something like a piece of clothing―a shirt, maybe―to put between your hands and the wound. “If you have gauze, fantastic,” he said.

A common mistake Bates sees people make is when they stop compressing the wound to check if the bleeding has stopped. Better to keep the pressure steady until the EMS arrive, he said.

Be sure to keep the bleeding person warm with blankets if needed.

“Cold blood doesn’t clot,” Bates said. “People who are hypothermic or cold, they will continue to bleed.”

4. Pack the wound if the bleeding area is large.

If the wound is large and deep, applying direct pressure with your hands will not suffice. This is when you want to heal the wound.

Hemostatic gauze is designed to speed up blood clotting and stop bleeding quickly. If you have it on you or in a first aid kit nearby, it is an ideal item to put in the wound.

If you don’t have gauze, “try the best you can with what you have,” Bates said. “Look for clean gear, something that isn’t full of dirt or grime. Maybe a clean towel or paper towel.

5. Proceed directly to a tourniquet if you determine that a limb injury is bleeding profusely.

There are emergencies where bandaging the wound or applying direct pressure will not suffice. Sometimes you try these steps, realize they don’t work, and move on to a tourniquet. But if you see blood doing what Bates calls “squirt-squirt-squirt,” get a tourniquet immediately.

“When you see the massive bleeding, it’s pooling or hitting the ceilings and coating the walls…you’re going to bypass all of that and go straight to the withers,” Bates said.

Inaba noted that tourniquets also work in cases where you have an injury to your extremities and need to move and cannot continue to apply constant direct pressure. “The advantage of the tourniquet is that once it’s applied you just leave it in place and you can remove your hands,” he said.

Keep in mind that tourniquets are only intended for the arms and legs; continue to apply direct pressure to wounds in the chest and other parts of the body.

Commercial tourniquets are more effective than improvised ones in an emergency. When done properly, commercial tourniquets effectively prevent blood loss by compressing the tissues in this area.

“It’s basically just flattening that blood vessel and stopping all that blood from coming through. By doing this, you cut off the blood flow from the heart to the fingers or toes and you stop the bleeding or loss of blood from that cut vessel,” Inaba said.

Bates said the commonly available combat application tourniquet, or CAT, is “one of the best there is.” The CAT and SOF tactical tourniquet, called SOFT-T, is recommended by the American College of Surgeons Committee on Trauma.

If you are in a public building, you may be able to find a commercial tourniquet in a bleeding control kit next to an automated emergency defibrillator.

Makeshift tourniquets should be a very last resort as they are not a substitute for a commercial tourniquet, but mass shooting research has shown that they work in an emergency. Bates finds that leather belts don’t work because they aren’t wide enough and aren’t tight enough, but he has seen a nylon clip work effectively. A person injured in the 2007 Virginia Tech shootings made an effective tourniquet for his gunshot wound with an electrical cord. First Care Provider, a veteran-run nonprofit seeking to teach the public about first aid, has produced a video that recommends using a carabiner and keychain if you must make your own tourniquet.

To wrap up the tourniquet 2 to 3 inches above the wound, then pull the free end of the Velcro band from the tourniquet, thread it through the loop and secure it at the other end.

Wind the windlass rod until you can no longer turn and traffic is cut off. Not tightening the tourniquet tight enough is a critical mistake that many people make.

“It’s just when I can’t feel their pulse anymore. This is how tight the tourniquet should be. We don’t want any blood coming in,” Bates said. “A the tourniquet is a very painful thing, but it is much better than bleeding to death.

Secure the rod by clipping it with another velcro strip so that your work does not come undone.

Finally, note the time the tourniquet has been applied, as leaving a tourniquet on too long can damage the tissues. Some tourniquets will have a blank space where you can write it down easily.

To learn more or become officially trained, take an official Stop the Bleed course in person or online. You can also ask your local fire department or EMS group to conduct training as well, Bates suggested.


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