It is a moment we all dread to think of, yet a life-threatening emergency can occur without any warning. Bleeding is one such emergency that can escalate into a critical medical situation requiring immediate intervention and transportation to a qualified medical facility for care. Bleeding can result from several injuries, from an ill-timed slice in the kitchen while preparing a family meal, to cuts sustained on the playground, to work-related injuries caused by machines and dangerous equipment, to the result of a vehicle accident, or, as seems to increasingly become the case, the senseless harm caused by an attacker at a public gathering.
Bystanders are often the first line of help during an emergency, providing immediate assistance while waiting for emergency personnel to arrive. During these critical moments, having the knowledge and tools to control bleeding can mean the difference between life and death. Bleeding is the primary cause of preventable death for those who experience trauma. Stop the Bleed is a national awareness campaign and training program aimed at empowering individuals to take action and effectively intervene during such emergencies.
To raise awareness of the importance of knowing Stop the Bleed techniques and encourage members of our community to become equipped and empowered to act when every second counts, Steward sat down with two of our experts on the topic. Peggy Higgins is the Trauma Quality Coordinator at Trumbull Regional Medical Centre, in Warren, OH, and Paul Elia is the Regional Director of EMS/Emergency Management responsible for both Trumbull Regional Medical Center, in Warren, OH, and Sharon Regional Medical Center, in Sharon, PA.
What is Stop the Bleed?
Peggy: Stop the Bleed is an initiative led by the American College of Surgeons that followed the Sandy Hook Elementary School shooting in 2012. A surgeon asked what can be done so that bystanders can render aid before EMS or even police arrive at the scene.
The result was a series of techniques that borrowed from best practices already used by the military, including the use of tourniquets.
Paul: The local SWAT and police also carry tourniquets and are trained to use them. However, Stop the Bleed allows members of the community to also render life-saving aid with the use of ordinary objects found in a daily setting.
What is a life-threatening bleed?
Paul: When classifying bleeds, think of a wound that is injecting bright red blood. This flow of bleeding will seem like it is pulsating because it is an arterial bleed. This may be the result of an injury such as an amputation, a knife injury, a saw injury, or a gunshot wound. Blood that is oozing is likely from a capillary source and is not life-threatening. Blood that is squirting out of the body cannot be treated with gauze and requires direct pressure and the use of tourniquets.
A key thing to remember is that it is not the size of the wound that matters, but where on the body the injury was sustained.
Peggy: What if you encounter a victim with no immediate sign of that forceful, pulsating blood? The victim may be experiencing an internal bleed. In those cases, look for signs such as a pale complexion, unresponsiveness, or non-alertness.
Whether you see a victim in a large pool of blood or blood projected with force behind it, call 911 immediately.
Paul: Any wound where the bleeding is not stopping or is not treated can become life-threatening.
How does Stop the Bleed work?
Peggy: Stop the Bleed is a temporary intervention to buy time to safely transport the victim to the hospital. There are approximately 5 to 6 liters of blood in the human body. If you sustain a life-threatening injury, you can lose blood rapidly. The goal of Stop the Bleed is to stop the flow of blood outside the body, keep the blood inside the body, and allow time to transport the person to the hospital to receive care.
Stop the Bleed uses three key techniques:
- Apply pressure: Use your hands or a clean cloth to apply direct pressure to the wound.
- Pack the Wound: If the bleeding is severe and continuous, pack the wound with gauze or a clean cloth.
- Apply a Tourniquet: If bleeding cannot be controlled with direct pressure, apply a tourniquet close to the site of the injury. Ensure that it is tight. Once a tourniquet has been applied, don’t take it off.
It is important to remember that for a wound sustained around the neck, armpit, or groin, a tourniquet cannot be applied.
Paul: The sequence to render aid to a bleeding victim starts with identifying the victim and dialing 911. Next, apply direct pressure for 1 to 2 minutes. If this is not working, move on to packing. For this step, it is best to use material that will absorb well, like a cotton shirt or towels. Apply new layers while continuing to apply pressure. Finally, apply a tourniquet.
Chances are that you may not have a tourniquet but will need to improvise and make one using material at your disposal. You can use a belt, rubber band, rope, or other piece of clothing that can be tied and tightened.
Peggy: When presented with an emergency, it is important to assess the situation and check for your safety as well as the victim’s. Ensure that there are no ongoing threats that could harm you or the victim. If needed, move the patient to a safer space. Use gloves or plastic bags when caring for the patient. The goal is to stop the bleeding; infections can be treated later.
Are there myths that may hinder someone from offering aid?
Peggy: One of the main reasons people may hesitate to help is that they do not know what to do. During an emergency, there is a role for everyone. There is a role for the person who dials 911, the person who helps to keep everyone calm, and the person who collects materials. It is important for someone who is concerned that they do not know what to do to remember that any help offered is more than the victim would have received during the time it takes for the first responders to arrive.
Paul: Another misconception is that once a first tourniquet is applied, a second will not work. This is simply not true. A second tourniquet can be applied if needed.
What resources are available to the community?
Peggy: One of the roles of local trauma centers is to provide training to their communities. Trumbull Regional Medical Center is a Level 3 trauma center that provides Stop the Bleed training to the surrounding communities. Community members or organizations that wish to organize a session should reach out to their local trauma center.
Also, visit the American College of Surgeons or the Red Cross to learn more about training opportunities. The local EMS or police departments may also be certified and equipped to offer training.
Paul: Everyone should be trained in Stop the Bleed techniques, from employers, staff, teachers, congregations, the police force, and the community at large.
Peggy: Even young children should receive training. Sometimes, they may be the only other person at home when a life-threatening injury occurs.
Stop the Bleed is more than simply a training program; it’s a call to action. We can save lives and create safer communities when we are empowered with the knowledge and skills to intervene during an emergency, including those involving severe bleeding. Immediate assistance is not limited to first responders and health care workers; if you’re a homemaker, caretaker, student, teacher, coach, pastor, shopkeeper, community volunteer, or any ordinary resident of your community, learning these simple yet life-saving techniques can make you a hero during someone’s darkest hour. When every second counts, the gift of life may be the result of your quick action and intervention.
If you are hesitant to offer assistance due to fear of litigation, familiarize yourself with your state’s Good Samaritan law to understand how you may be protected when offering assistance.
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