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August 19, 2019

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Weekend doctor: Stop the bleed

By Douglas Yoder, MD
Surgical Associates of Northwest Ohio
Bleeding has been identified as one of the three leading causes of preventable trauma deaths before reaching the hospital, responsible for up to 40 percent of all deaths from trauma. Bleeding quickly catches our attention.

At home, work or play, bleeding is a sign of something that is not right and could potentially be serious or even life-threatening. For instance, accidental cuts from kitchen knives, table saw injuries or chainsaw lacerations happen frequently. For hunters, accidental gunshot wounds can be lethal unless aid is provided early.

Locally, large lacerations can even result from a high school sporting event. Accidental amputations from the workplace have also been treated. Furthermore, tragic school shootings have increased the importance of controlling bleeding prior to receiving medical attention from paramedics or in a hospital.

The American College of Surgeons has established a program to address this issue called “Stop the Bleed.”

This training is intended for everyone. For instance, teachers and school administrators are important first responders in the event of a school shooting. Students can also be effectively trained. At the workplace, co-workers are valuable. Parents, grandparents, neighbors and friends can all learn how to stop potentially life-threatening bleeding.

To stop a bleed, you must act quickly! First, call 911 and get help. Next, it is important to hold direct pressure on the bleeding site. One or two gloved fingertips placed directly on the spot that is bleeding and holding firm pressure can effectively stop even significant bleeding. You can use a clean cloth, rag or even a piece of clothing to place directly on the wound prior to holding pressure. However, applying pressure with the entire hand or palm is much less effective no matter how hard you press and should be avoided. Wrapping a bleeding site with gauze or a towel will not stop significant bleeding and should also be avoided. Ideally, sterile gauze is used but not always available. Do not be surprised if placing firm pressure on the bleeding site causes significant discomfort. Try to soothe and reassure the injured individual. 

Tourniquets can be life-saving when bleeding occurs in the arms or legs. These are devices that encircle the bleeding arm or leg above the bleeding site and cuts off the blood supply to the limb when twisted. Proper placement and usage will stop bleeding. This is a quick but temporary solution to the problem, and rapid transfer to medical care is essential. Make a note of the time that the tourniquet was placed. Since this is important information for medical professionals to know, it may be helpful to write this time directly onto the limb that was bleeding. Unfortunately, similar to applying pressure, a properly placed tourniquet will be painful for the injured individual. It is important to comfort and reassure the patient and get him/her to professional medical care.

With the exception of a tourniquet, many of us have the needed equipment at home to stop bleeding. If you own a first aid kit, it is a good idea to every so often make sure it is adequately supplied. Gloves and gauze are the most important items. Additionally, tourniquets can be purchased from online. Entire kits that include all necessary equipment are available online but can be expensive. These may not be needed for the home, but well-stocked bleeding control kits should be well-positioned in classrooms and workplaces in addition to CPR-related equipment, such as an automated external defibrillator (AED).

While we hope that we are never in this situation, we never know when or if an injury will occur that could cause life-threatening bleeding. If it does, proper training, equipment and willingness to help control bleeding can save a life.