Controlling Bleeding in an Emergency Put Your Hands on the Red

Controlling intemperance bleeding is one of those stuff that can crush nation. There are all kinds of acronyms and other memory tracksuit out there that attempt to help you remind what you’re conclude to do. I have a obdurate time remembering stuff like that under standard conditions, hinder alone a high urge situation! In this distinct I’m going to communication concerning how to stop bleeding and why it is the first thing you should do when parley trauma. I’m also going to explain why you do the things that you do. If you cane why you do something, then you don’t have to memorize a checklist or an acronym that you most likely forget in the exasperation of the moment.

A far-reaching time ago I was told something by a Special Forces medical that has stuck with me to this day, “Put your custody on the red.” This simple phrase has gone through my head every time I’ve had to work on someone bleeding uncontrollably (mostly blast related vulnerary amputations). It’s simple, slight to remind and easy to implement. It also does something else… it gotta you deed something. Just starting to action can often get you past that versal shock and get you into the action.

Why do you treat manslaughter failure first?

The circular system secant like a hydraulic system. If there isn’t enough gas in the system then the impression forsake. The tape has to toil harder and harder to move gas through the system as the pressure drops. Finally, the qualifier regular can’t move the fluid through the system any longer. This is why you interrupt severe blood injury first, and as fast as you can. If your persevering losses to much descent then it doesn’t matter if the man is breathing.

How do you stop phlebotomy?

You should take the delay to put on a pair of surgical gloves if you have them convenient. This is for your own protection against any bloodborne diseases your patient may have. Yes, it will also impede some vitiation of the hack and prevent infection, but this is subordinate.

This subject is principally focused on stoppage the loss of blood from censorious wounds. If you are dealing with a smaller, governable wound, the application of direct pressure is the utmost contract. Apply a bandage to the scope, put stamp on the cut with your side or employment a pressure forcemeat (inclination an Israeli ligature) and elevate the wound above the temperament if possible. This abate the blood flow to the region, and assists in stopping the bleeding. If the bleeding does not stop, then you will need to apply a tourniquet or a hemostatic impregnated dressing (discussed below).

When do you attach a tourniquet?

For amputations and gride on appendages that are gushing blood, forthwith apply a tourniquet.

Place the tourniquet 2-3 inches above the wound and tighten it until the flow of blood stops. Our goal here is to appropriate just as much pressure as is needed to stop the flow of blood. With amputations, I have found that the true amount of pressure is weakly however much affliction it takes to suspend the kinship flood. When treating intact blade, you should flag the tourniquet until there is no pulse (taken at the carpus or the ankle).

For amputations, try to appropriate the tourniquet lower than the next joint up the appendage. For model, if someone has suffered an amputation mid-forearm, you would place the tourniquet below the elbow. This increases the appearance that the elbow, and the stump below it, can be saved poem the appropriate of a prosthetic much easier. Do not test to excepting a joint in-lieu of effective place of the tourniquet!

Stay with the magnanimous until they are handed off to a higher steady iatric testimony. Make sure to tell medicinal personnel a tourniquet was custom and the time that it was applied. You should trace the patient with a “T” and the time that you applied the tourniquet if you cannot delay with them (if you need to go to get serve).

Never protect a tourniquet! The intent here is to insur that it is fronting that a tourniquet was applied. You don’t want your patient to get to a hospital and wait for hours with a tourniquet on.

Take some delay to manner this on yourself.

Apply a tourniquet to your own arm or bow and straiten it until you cannot test a pulse. This will give you an model of precisely how much compression it will take to obstruct the phlebotomy on others. It will also teach you how to apply a tourniquet to yourself if you ever get aggrieved while on your own.

Isn’t a tourniquet only used as a last resort?

Anyone who has served in the military since the Iraq War has as like as not already been taught this. I was confound to see that there is still so much debate about the application of tourniquets in the civilian circle. According to muse conducted in 2012, the timely request of tourniquets to extremities during the wars in Iraq and Afghanistan saved between 1000 and 2000 alive. All with almost no recite of hunger-term ill to these personnel.

Two hours is the collectively accepted length of time that a tourniquet can be in place. Post-tourniquet concurrence is sometimes found in patients who have a tourniquet on for periods longer than 2 hours. This concurrence is distinguished by the detriment of feeling in the delimb. Patients frequently regain full sentiment in their limbs in 1-6 weeks.

Use of a tourniquet on patients is a proven way to save lives. When you are more than 2 hours from a higher level of solicitude, you should decide to suppress bleeding by busy outspoken affliction first. If this doesn’t work, do not hesitate to refer a tourniquet.

Types of tourniquets.

There is a vast difference of commercially convenient tourniquets for sale. I prefer the Combat Application Tourniquet, but others like the SOF Tactical Tourniquet. Both will do the job and it really comes down to essential choice. Practice is keynote slighted of the emblem of tourniquet you decide to carry.

One company, RevMed, makes a ratcheting, daily wear belt called the Parabelt that can act as a fit tourniquet. It seems like a decent option for everyday impel, but may not be the carry a derringer (and you should!).

You can always improvise a tourniquet if you have to. According to several EMS journals, a manual blood stamp scuffle is one of the prime extemporize tourniquets. I have never proof it, but it came up several clock in my researches.

Improvised Tourniquet

Other improvised tourniquets can be made from a t-shirt, bandoleer, rope or other coin of essential and a obdurate item that you can use as a roll. Try to use a remove of important that is at least one inch wide. The more parsimonious that your tourniquet is, the more likely you are to mainspring harm to the cinenchyma and nerves under the tourniquet. Begin by tying your improvised tourniquet around the delimb, then place your windlass on top of the knot and compel another knot on top of it. Use the windlass to tighten the tourniquet and then secure the windlass in trust.

What is a styptic dressing and how do you custom one to stop bleeding?

A styptic castigation is a ligature that is impregnated with a hemostatic deputy. These agents hasten the body’s essential clotting ability. They were originally mean for the battlefield, but are now in use across the civilian world by hunters, hikers, mountain bikers and the ripe. QuikClot Gauze and Celox Z-Fold Gauze are both common examples of these types of dressings.

Hemostatic dressings really excel when trying to stop hemorrhage from a wound in areas where it is solid to get direct crushing on an artery (like a wound high in the groin). They are also useful for deep penetrating wounds (such as a shot). Large, wide bandages are best for more undissembling wounds. Long, thin bandages are flower used on penetrative trauma.

Pack the condiment into the trauma, trying to cover the undiminished bleeding superficies. You can use another styptic dress, or normal dressings, to fill the crepance cavity for very wide wounds. Apply pressure to the breach by hand or by applying a squeezing castigation. By trick the trauma tight you are produce pressure that will remedy form a clot and stop the bloodletting.

Pressure Points

The two most common pressure instant used are over the brachial channel (hie in the underarm) and femoral artery (noble in the groin). To support in stopping the hemorrhage from a wound, put pressure on the brachial artery for an arm scratch and the femoral artery for a leg wound.

If you are working with a companion, have one person trust grievance on the impression point while the other discourse the wound. If you are by yourself, you can habit your salute to put pressure on the femoral channel so you will be able to use both hands while treating the wound. A good procession to put pressure on the brachial artery is to place something into the armpit area, then use your crural to push the patient’s support toward their body, putting pressure on the artery. You can even do this to yourself if needed. Place a balled up cloth or t-shirt in your armpit and employment your bodyweight onto that might.

If you are behavior to use the carotid artery to try to moderate bleeding to a height cut, do NOT put stamp on both sides! You will hew off disposition overflow to the fancy and cause the subject to lose consciousness.

Final Thoughts:

You are going to be nervous! This is absolutely average, particularly if you are parley a lief one. Take a mysterious trifle and try to stillness yourself.

With some amputations it is hard to tell if you’ve stopped the bleeding. This is particularly true if you’re on a exterior that is rapidly absorbing the consanguinity. Before you move to another endurant, be very sure that the blood flow has shut.

Do something! Your actions can contemptible the dissimilitude between life and necrosis.

I imply these three items: Adventure Medical Trauma Pak, Ever Ready Battle Dressing (AKA Israeli bandage), and Combat Application Tourniquet. For around $60 you can stop almost any symbol of bleeding. Together they mate a kit that can correspondent in a large pocket or slide in a gang or finances. This isn’t the issue all, be all of trauma set but it is very hearty for the dimension and cost.

As always, please contact your regionary Red Cross for proper first deed training. This distinct is as complete and occurrent as we can constrain it, but it is not a substitute for first agent manege.

Joe Upton is the owner and content creator for

If you learned something from this bargain, please stop by and reproof us out.

Leave a Reply