No matter how fast EMS responds, a person can bleed to death in as little as 3 to 5 minutes. That’s faster than many EMS systems can respond to the scene. And research has shown that as many as 20% of traumatic injury deaths by hemorrhage could have been prevented with emergency measures to control bleeding. Rapid public access to bleeding control products reduces time to treatment and saves lives in incidents of severe hemorrhage.
This is the basis for the Department of Homeland Security's "Stop the Bleed" program, a nationwide campaign to empower individuals to act quickly and save lives.
This year, national Stop the Bleed day is March 31, 2018. To help raise public awareness on the importance of emergency action to prevent death by blood loss, we’ve compiled a list of the top 6 most critical emergency medical products to use in mass casualty and emergency trauma situations.
Selecting the right medical equipment mix is dependent on your level of training—which products you know how to use, or are willing to learn, and how confident you are with your ability to use those products in stressful situations.
A tourniquet is a critical piece of life-saving gear in the event of penetrating trauma to an extremity and is probably the single most valuable medical product for prevention of death by exsanguination (bleeding to death).
Lessons from conflicts in Iraq and Afghanistan and more recently with adaptation by tactical law enforcement teams have demonstrated low rates of complication with the use of tourniquets and that they have a significant survival benefit, especially when applied prior to the onset of shock. SOFT-T and the CAT (Combat Application Tourniquet) Tourniquets are made in such a variety of forms that selecting the best one for your own purposes can be confusing. The most highly rated ones may or may not be suited to your situation.
Windlass-driven tourniquets are most popular in Military and Law enforcement, while products such as the SWAT-T may be more intuitive and faster to apply for the average layperson. We strongly recommend that you become familiar with your tourniquet of choice, practicing both right and left-handed application on yourself and others.
Wound Packing Gauze
Effective wound packing, using gauze or hemostatic agent treated gauze can significantly reduce the amount of time that direct pressure must be applied to an arterial bleed. This is especially important in the event of a mass casualty incident. For people with minimal training in wound-packing techniques, hemostatic gauze can make their efforts to stem bleeding more effective. These techniques are quite simple but do require training to be effective.
Agencies and professionals in EMS, Military, and Law Enforcement have been increasingly including hemostatic gauze in their IFAKs and everyday carry trauma kits, despite the significantly higher cost over conventional gauze.
Pressure Dressing and Bandages
Designed and packaged with volume and weight reduction in mind, these dressings come in several configurations. The popular Israeli Bandage consolidates multiple first-aid devices—primary dressing, pressure applicator, secondary dressing, and a foolproof closure apparatus to secure the bandage in place.
Other designs, such as the Olaes Bandage, incorporate wound-packing material (gauze) along with the ability to apply direct pressure to a wound site and to cover/protect the wound. These bandages are proven to restrict blood flow from a penetrating wound.
Shears and Strap Cutters
While shears may seem like a frivolous add-on to those who routinely carry a knife, they are safer for the patient and much easier for the first responder to cut away clothing to obtain access to a wound. This small investment can save precious time when seconds count.
If you are in a situation where a trauma kit is needed, you will either be treating a patient, yourself, or someone else could be using it to treat you. In any instance, the first responder should take precautions to limit exposure to very serious bloodborne pathogens (HIV, Hepatitis, etc). For the small cost of a pair of nitrile gloves, they are an excellent investment.
Casualty Extraction Litter
While an extraction litter is technically not a bleeding control product, getting the injured quickly and safely out of the hot (danger) zone and to a collection area is critical to improving medical outcomes. Lightweight, portable and inexpensive, disposable litters are usually constructed of nylon webbing backed with nylon or non-woven fabric. Patients can be carried or dragged using these devices, making them a good investment in preparedness, especially for institutions, transit hubs, and venues.
The Reality of Today's World
It is a hard reality that we are all at risk, regardless of our professions or recreational preferences. And, while the national Stop The Bleed initiative is gaining traction, this effort will not guarantee that life-saving gear is available whenever and wherever needed. That responsibility will forever rest with the general public. To find a stop the bleed training course we suggest the starting the search on bleedingcontrol.org
All the components discussed above are available in personal trauma kits, public access pre-built trauma kits or IFAKs, but it is worth considering building your own kit using only those components with which you are familiar.
If you are still not sure about the best way to proceed, consider starting small and simple with a tourniquet and a trauma dressing. Those two components alone can cover a large percentage of severe bleeding cases. Search for instructional videos and read product reviews for the most widely used tourniquets and trauma bandages. Base your choices on what seems the most understandable to you and look for proved manufacturers and sellers.
Note: It is NOT recommended to practice with a windlass tourniquet, as they can stretch out under repeated use, making it difficult to attain hemostasis (stop bleeding) when actually needed. Strap-type tourniquets like the SWAT-T or TK4 are not so easily degraded by practical application.