Hunters, anglers, backpackers and others who explore the outdoors have long known to carry a first aid kit with them. But does it have the tools to stop major bleeding?
Bob Frye / Everybody Adventures
A nationwide effort borne out of tragedy may help save the lives of hunters, anglers, hikers, paddlers, backpackers and others who wander in remote areas, far from care.
It’s called the “Stop the Bleed” initiative.
In December of 2012 a 20-year-old man named Adam Lanza shot and killed 26 people at Sandy Hook Elementary School. Twenty were children ages 6 and 7, six were staff members.
Lenworth Jacobs, director of the Hartford Hospital Trauma Institute, where victims were to be transported, determined that at least some of those deaths were preventable. Victims died not immediately after being shot, but because of bleeding.
That’s not unusual. Bleeding is the number one cause of preventable death after injury, said Matthew Neal, a UPMC trauma surgeon.
So Jacobs suggested teaching ordinary people – themselves potential “soft targets” or at least bystanders to tragedy – how to change that. The Stop the Bleed initiative is the result.
Its goal is to empower people, be they in an office, at the mall or in the backcountry, to help themselves and others by controlling bleeding until care can be reached.
“You don’t need formal medical training. You don’t need to be an EMS. You don’t need to be a physician or a nurse,” Neal said. “These are basic skills and basic techniques that anyone can use to stop life-threatening bleeding.”
The initiative works in two parts.
One is based on equipment. The initiative aims to get bleeding control kits placed into public buildings, much like AED kits.
Charlotte Douglas International Airport – the seventh busiest in the world based on takeoffs and landings – has been equipped with bleeding control kits that contain pressure bandages, hemostatic dressings, tourniquets and gloves, for example. The intent is to get more kits in more public places.
UPMC, for one, is using part of a $1.3 million grant to put a similar kit in every public school in western Pennsylvania.
The other part of Stop the Bleed involves training people everywhere how to control bleeding.
Anyone who finds themselves in an emergency situation should look to their own safety and call 911 first, Neal said. After that, though, look to offer aid.
That’s easier than many might imagine, he said.
“Stopping bleeding is not as challenging as it may seem. What you’ve got to do is identify the injury, so you need to see it, to know where it is, and then stop the bleeding,” Neal said.
If the injury is what’s called a “junction” wound, meaning to the neck, groin or under an armpit, it’s best to apply direct pressure first, Neal said. That means pushing hard.
“It’s arms together, elbows locked, as hard as you can push, until there’s a strain in your voice,” Neal said.
Keep that up for at least three minutes if using a bandage that had a blood coagulant in it, 10 minutes if not.
If that doesn’t work, pack the wound. Use gauze if it’s available, Neal said, but whatever’s handy, even the T-shirt on the victim’s back, if it’s not. Push as much of that material into the wound as possible, then use what’s left to apply pressure atop the wound.
Don’t worry, as some do, that the shirt might be dirty or sweaty, Neal added.
“What I would tell you is, if you bring me a patient where you’ve stuck the dirtiest rag in a wound, I will take care of the infection. I cannot deal with that if the person dies and never makes it to the hospital,” he said.
If the wound is to an extremity, like an arm or a leg, apply direct pressure again, Neal said. But if that doesn’t stop the bleeding, use a tourniquet.
Get it as high up on the arm or leg, near the armpit or groin, as possible and make it as tight as possible, until the bleeding stops, Neal recommended.
Applied correctly, a tourniquet will hurt, he said. But leave it on.
“Don’t take it off, don’t loosen it, don’t worry about how long it’s been there. We have people that are transported to us from an hour away with a tourniquet in place and their limb is just fine,” Neal said.
“Once a tourniquet is in place, only a health care provider should remove it.”
Stop the Bleed was created because of mass casualty shootings, But accidents that result in major bleeding can happen anywhere anytime, Neal said. That’s especially true for outdoorsmen and women who spend time with firearms and bows, or at least in places far from care.
Neal suggested buying some minimal gear — gauze, QuikClot-type dressings and tourniquets – and carrying it outdoors.
He even carries it in his vehicle, he added.
Why? Because when major bleeding starts, as tragedies have shown repeatedly, time matters.
“It doesn’t matter what EMS agency you have. The most fabulous, fastest-responding EMS agency has an average response time of six to eight minutes,” Neal said. “Bleeding from an arterial wound can cause enough blood loss to lead to death in as little as three minutes.
“So when you’re out far away from care, and a long way away from a paramedic or a hospital, you need to be empowered with the tools and techniques to stop major bleeding and save a life.”
Additional resources
= Live in western Pennsylvania? UPMC is willing to talk to you about Stop the Bleed.
The health care provider is willing to do programs on how to stop bleeding for sportsmen’s clubs, scout groups, churches and other organizations for free. To schedule something, email stopthebleedtoday@upmc.edu or check the website here.
= If you want to learn how to apply a tourniquet, Lenworth Jacobs has put together an instructional video here.
= Additional details on the Stop the Bleed program are available from the Department of Homeland Security here and from Bleedingcontrol.org here.
= If you want to buy an emergency kit, two sources are North American Rescue, available by clicking here, and Control Bleeding Kits, available by clicking here.
= Lastly, the image below offers step-by-step instructions on controlling bleeding.
