21 December 2012

How to Save Yourself or Someon Else from Bleeding to Death

There are all kinds of information out there when it comes to first aid, and now it seems even more about “tactical” medicine. This has pros and cons. The biggest pros are that more people are looking for information and carrying first aid kits. The con is that just as in using a firearm in a personal protection situation, few people can imagine the intensity of a situation where someone is bleeding out.

One of the hardest things I ever had to watch was doctors putting an IV into my infant son’s temporal artery in his head. He was a heart patient at Johns Hopkins. He was only 8 lbs. I started running with EMS when I was only a teenager; by the time my son was born I had been a police officer for several years. I had seen shootings, stabbings, suicides, unattended deaths, and brutal motor vehicle accidents. But when it is your kid, someone you love, it is just different.

If you are reading this, there is a good chance that you are the one in your family who will be expected not to freak out when something bad happens. You should know CPR, that is a given. There is not too much first aid you can do for a traumatic brain injury. But when it comes to stopping bleeding, there are a few simple things you can do, in a short period of time that can save yourself or someone else. There is also a great chance that it will be a loved one.

The simplest is by applying direct pressure to the wound. One time my partner and I responded to an EMS call. We were the first two on the scene. The patient was drunk and fell through a glass coffee table. One shard of glass punctured his femoral (major artery of the leg) about 6 inches below his groin. The first aid I did was pretty advanced. I took a bath towel put it on top of the spurting wound. Then I stood on it until EMS arrived. He lived. That is the most “caveman” example of direct pressure I can give.

A few months ago I was out of town training, when my wife called to say that my little one had fallen through a storm window. She sliced her hand pretty good. They were taking her to the ER and already using direct pressure. I instructed them to elevate her hand and apply pressure to her brachial (major artery of the arm). The combination of the three stopped the bleeding and she ended up with nine stitches.

Think of the site of injury as the faucet. The arteries running to it are like garden hoses. And your heart is the pump.  Direct pressure closes the hose and allows blood to run through and clot at the wound.  Elevation makes the blood have to run up hill to the wound site.  Pressure points press the hose closed.

These three things will work for 99% of what you are likely to encounter. But in rare circumstances, the only option is a tourniquet. The idea of a tourniquet is that it closes the hose completely.

Some hold the position that because we usually only have to wait minutes for EMS to respond we don’t need to use a tourniquet. I believe it is better to have the training to use or make an expedient tourniquet. Depending on the wound, a person can bleed out in just minutes. What if-
  • The initial ambulance crashes on its way to you?
  • What if you give them a bad address?
  • What if they get lost anyway?
  • What if for an environmental or situational reason delays their response?

Many things can be used for a tourniquet, just ensure that they are wide enough so as not to cut into the skin. Think belt, not parachute cord.  I make a habit of always carrying a bandana with my wallet.  Among lots of other uses, along with a pen it makes an excellent tourniquet.

You can only tourniquet the extremities (arms and legs), and then only if you can place the tourniquet between the site of injury and the heart. For example you could not use a tourniquet in the armpit or crotch area.

Plan for the worst. Hope for the best.

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