Stop the bleed: Educators offer training for life-threatening bleeding
Registered Nurse Julie McFadden repeatedly instructed her class of students, “pack and hold, pack and hold,” because those steps can save lives in cases of life-threatening bleeding.
During a training for firefighters with the Oak Creek Fire Protection District last week, McFadden showed how to pack gauze or any available cloth directly into a severe or deep bleeding wound to compress the source of the extreme blood loss. Then, individuals providing aid must hold that packed and compressed wound with strong pressure from the heels of both hands until professional medical help arrives. The posture for applying pressure is similar to the CPR pose, McFadden noted.
“If you get tired, use your foot or leg, but do not release the pressure to check the wound because it will pull off the clot. No peeking,” McFadden instructed. “Do not take it off unless you can fix it.”
As the manager of trauma services at UCHealth Yampa Valley Medical Center, McFadden knows the importance of co-workers, friends or bystanders learning the proper way to stop severe bleeding at a site of a traumatic injury. McFadden teaches the Stop the Bleed course designed by the American College of Surgeons that explains, “The number one cause of preventable death after injury is bleeding.”
Educators from YVMC are available to teach Stop the Bleed classes for free. McFadden said the approximately one hour training can provide life-saving information for anyone but is especially important for sports coaches, school staff, backcountry enthusiasts and recreation guides.
The basics of Stop the Bleed instruction are ‘A’, ‘B’, ‘C’. The ‘A’ stands for “alert,” meaning alert responders by calling or texting 911. The ‘B’ stands for find the bleeding injury or possibly multiple bleeding sites and ‘C’ stands for compress or apply pressure to stop the bleeding.
Along with longtime Registered Nurse Marti Potter, a life support instructor at YVMC, McFadden told the firefighters to use any clean cloth, such as a T-shirt, to push into a deep wound to apply pressure on the bleeding vessel. Pack the major wound with cloth until the wound is full, then apply pressure directly. If a clean cloth is not available, use any cloth even if it is dirty because stopping life-threatening bleeding is the number one priority. Any contamination or infection from a dirty rag can be treated by medical professionals later.
The nurses advised placing the compress directly on the wound instead of on top of clothes. Never pull off the packed compress but reinforce on top of the cloth instead, they said.
Traumatic injuries may come from a variety of sources such as sharp skis slicing skin, motor vehicle crashes, or glass shards. The trainers encouraged everyone to review first aid kit equipment and to keep a first aid kit in an easily accessible place such as in a vehicle glove compartment or at the top of a backpack.
“We want you guys to know what you have, where it’s at and how to use it,” McFadden instructed.
In the case of continuous, large-volume bleeding that does not stop from the “pack and hold” technique, a tourniquet might need to be applied two to three inches above a severe wound. Both Potter and McFadden advise when buying a tourniquet to invest in a CAT style, or “combat application tourniquet,” that costs about $30. A rubber band style tourniquet may break and is more difficult to apply to oneself if needed.
The trainers guided the firefighters through a practice session of applying, tightening and securing a tourniquet on their arm, leg and their partner. Tourniquets are best applied on the skin and should not be applied to joints. The nurses noted that stopping truly life-threatening blood loss by tightening a tourniquet until the bleeding stops is more important than the concern of cutting off circulation to a limb.
“Time it for medics, but it can stay on for hours without doing any damage,” McFadden said of a tourniquet necessary for uncontrolled life-threatening bleeding.
Injured people may be in increased pain due to the tourniquet, but a properly applied tourniquet is best removed by professional medical personnel. The American College of Surgeons does not endorse searching for a homemade tourniquet such as a belt or shoestring but rather to quickly pack the wound and apply pressure.
As another warning, people should first quickly assess the injury scene for their own safety, looking out for everything from biting dogs to falling tree branches so that the rescuer does not also become a victim.
To reach Suzie Romig, call 970-871-4205 or email sromig@SteamboatPilot.com.
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