My Emergency First Aid Kit (Blowout Kit) is set up for severe trauma. It is designed to stop bleeding and breathing problems from trauma like gunshots. Today lets look at stopping bleeding. Someone can bleed out in minutes. A normal adult has about 6 liters of blood, and it takes losing over a liter before someone is in serious trouble (1 liter is about 32 ounces or a large coke). It seems like a lot, but your heart is an amazing pump and can put that out in minutes.
It’s generally easy to see if someone is in trouble from bleeding out. When someone starts bleeding through clothing and dripping, or blood starts pooling, treat it as an emergency. The four basic steps to stop bleeding are; direct pressure, elevation, pressure points, and a tourniquet. It’s much easier to stop bleeding on a limb then on the body, so let’s start there.
Use direct pressure, push hard, with a gauze pad, cloth, or out of my kit I would use a First Aid Dressing out of my kit. It even has straps to tie it off so it will hold pressure all by itself (that’s why I like them so much). If the bleeding looks bad I could go to the Israeli Battle Dressing. It’s like an ace bandage with gauze and a clotting agent in it. Bleeding stops because it clots, or sticks to everything including itself when exposed to air. So everything we do, is to help that process. We put a bandage, gauze, or cloth (in emergency) to give the blood something to clot on. On that point, if the bleeding is so bad that it soaks through the first thing you put on, put something over the top, don’t pull off the first layer. If you pull off the first bandage it pulls away all that blood that is already clotting and starting to plug the hole.
If direct pressure isn’t working right away, elevate the limb over the heart. It will keep a little less blood flow to the area. There is some argument on whether this helps or not, but I would use it anyways, because it can’t hurt. Just hold up the persons arm or have them lie down and hold up their leg as you are working.
If that isn’t working, try pressing on the pressure points. On the arms pinch the inside between the bicep and tricep. You are trying to pinch off the artery between you hand and the bone. On the leg you are looking for the main artery on the inside of the thigh. It’s deep in there, use the heel of your hand and push hard. You are trying to slow the flow of blood. If you are doing it right your patient will feel discomfort, or even a little pain.
If this doesn’t slow the blood flow, go to a tourniquet. A tourniquet is designed to stop the blood flow to the limb. The ditty we used use was life or limb, because the belief was that if you used a tourniquet that the limb would have to be amputated later. But this has been proven not to be true again and again. The military now talks about the golden hour. It refers to the first hour after an injury, all the training is going towards keeping the patient alive for that hour and getting them to help. We need to think about it the same way. If the first three things didn’t work your patient is in danger of dying before professional help can get there. You have to stop the bleeding.
I carry two different types of tourniquets because of space. I love the SOF Tourniquet. It’s the easiest and fastest to use, and with medal parts I’m not afraid to break it. I keep mine hooked inside the buckle and ready for use. I also have a TK4 as a back up or secondary because it’s small and light. I can use both one handed (so I can apply it to myself or hold pressure on someone else’s wound while I put it on). If the wound were to myself, I would go to a tourniquet way faster then on someone else. First, you can pass out from blood loss, so If I pass out from without stopping the bleeding and there isn’t someone else around, I’m done. Second, it’s hard to doctor yourself. The injury is painful and so is the treatment. I don’t want to lose my resolve before the blood flow has stopped. And lastly, it’s faster so I can get myself to professional help during that first hour.
If you put on a tourniquet, it’s okay, and the person will be okay. The info the doctor needs is the time it was applied. That’s where the sharpie comes in. After you put on the tourniquet write T and the time you applied the tourniquet on the person’s forehead as big as you can. Make notes of any other things you did to stop the bleeding on the person’s shirt with the sharpie. That way there is no “I think” this was done when you get to the hospital. Also send the package of any bandages, gauze, or any other products you used to help the person with that person to the hospital. If you have to doctor yourself, make notes the best you can anywhere you can. Stuff the packaging into your pockets from anything else you used. That way the doctor that will finish the job will have all the info he or she needs to save the limb and help the patient fully recover.
In the next post I’ll go over step by step on how to use a tourniquet. Get yourself one and practice a couple times, it could save a life.