What to do in case of bleeding

By Alan Koenigsberg, M.D.

This past week, we had two nurses from a local hospital run a class called “Stop the Bleed.” It is a roughly one-hour class, designed by the American College of Surgeons and the Department of Defense. It is designed for the general public and is a basic training to help people come to the aid of an injured person who is seriously bleeding.

You can find more information at the website: www.stopthebleed.org/.

The number one cause of death after an injury is bleeding. Therefore, if we are trained to provide aid to someone who has been injured and is bleeding, we can provide lifesaving assistance until emergency personnel arrive.

Just as for those with CPR training, rendering assistance is not mandatory. One is not obliged to help. Having this training provides an opportunity.

The first recommendation is to always ensure one’s own safety. Otherwise, there may be two people who need help.

Also, please keep in mind these are guidelines and there may be exceptions. For instance, it was recommended to move the injured person to an area of safety if for some reason it may be risky to remain in place. However, we are also instructed not to move an injured person if there is a risk of a neck injury, as that might cause further injury to the spine and paralysis.

It is also important to recognize that if an injury is severe enough to cause copious bleeding, there could be other bodily or organ damage, such as broken ribs or a head injury.

If this sounds complex and potentially confusing or overwhelming, it’s because evaluation of an injured person can indeed be overwhelming and confusing, even for trained medical personnel.

The intent of this brief course, as well as others, is simply to provide some guidance and the opportunity to help others in need.

The core points:

1. Apply pressure directly to the wound.

2. Pack the wound.

3. Apply a tourniquet if the pressure and packing don’t stop the bleeding.

When coming upon a person who is lying on the ground and showing obvious blood coming from them, seek to identify where the wound is. Is it coming from the arms, legs, torso? You then press, with intensity, directly onto the wound. This will hurt the person, but modest pressure often doesn’t work.

Hold the pressure until emergency personnel arrive.

You can press directly on the wound with bare hands, gloves, a shirt or anything else available.

If that doesn’t stop the bleeding, find something to literally press into the wound. If a stop-the-bleed kit is available, as we have in the lobby of our synagogue, use it to find some gauze to use for packing. If that isn’t available, use whatever is, such as a T-shirt or washcloth. Don’t use tissues or other material that will dissolve.

As a last option, apply a tourniquet two or three inches above the wound and secure it very tightly. It will hurt. Leave it on and don’t remove it. When applying a tourniquet, write down the time is was applied, either directly on the tourniquet or anywhere it will be seen. If no pen is available, a finger dipped in blood can write a time on clothing.

Please keep in mind that I am not providing a certified course in this brief description, but rather an overview of what the nurses in the course taught us. Please don’t rely on just the few sentences I have written, but if you are interested, check the website for courses available near you.

Knowing what to do can save a life.

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas. He can be reached at akoenigsberg@mac.com.

Leave a Reply