Stop the Bleed, the national campaign initiated by the White House in response to the many recent active shooter incidents in the U.S., has garnered significant attention and support over the past two years. Active shooter situations, coupled with research that has come
Stop the Bleed, the national campaign initiated by the White House in response to the many recent active shooter incidents in the U.S., has garnered significant attention and support over the past two years. Active shooter situations, coupled with research that has come out of the conflicts in Iraq and Afghanistan, have helped us clarify that the greatest cause of preventable death after trauma is uncontrolled hemorrhage, whether internal or external. In the treatment of myocardial infarction, it has long been said that “time is muscle.” Similarly in trauma, we now have a greater understanding that time is red blood cells and every RBC counts toward the ultimate survival of the trauma patient.
As a direct result of this realization, several neglected hemorrhage control techniques have become major components of civilian medical educational programs designed to train citizen responders, public safety personnel and medical care providers of all levels. These include techniques that were once performed only within the confines of the OR — such as packing a bleeding blood vessel — and interventions that were long frowned upon — namely, tourniquet application.
While these hemorrhage control techniques are not particularly difficult to learn and master, there are a number of pitfalls related to performing these interventions that can negatively affect the ultimate outcome of the trauma victim.
1. Not using a tourniquet or waiting too long to apply it for life-threatening extremity bleeding
For many decades the traditional teaching has been that the application of a tourniquet was the procedure of last choice 