STOP THE BLEED

By Mike D

cvpreppers.com

Why are we worried about stopping the bleed? Why not airway, breathing, and transport?

Well, we are worried about the airway, breathing, and transport. But if you have an artery that is severed or nicked, by the time you establish an airway the victim could have bled out and is dead. This is what we are going to learn to prevent.

The average male at 180 lbs. has 9-10 pints of blood in the body and the heart pumps about 5 liters per minute. Pressure loss in the body will take 1-2 minutes. That’s why stopping the bleed is so important. If you see blood squirting the heart is still beating, so you don’t have to worry about an airway and breathing. The heart is still pumping oxygen rich blood through the body.

Over the past twenty plus years of war there has been some important advances in battlefield care. A few of these are the use of tourniquets, IO iv’s, and clotting agents. You are thinking the battlefield! What does that have to do with us? Stop the Bleed is usually associated with an active shooter situation or combat, but these are very isolated incident’s unless you live some place like Chicago. What about accidents at construction sites, hunting, 4x4, hiking, climbing, boating, car accidents, and that's just a start. There are many ways and places accidents can happen. Best to have the knowledge and equipment before its needed.

Let’s start with equipment. You will need a backpack that can hold at least a 100 pounds of gear and $1000.00 worth of supplies to fill it. No not really, a small kit with the right tools is all that is needed. A IFAK (Individual First Aid Kit) is where we will start. You can buy a premade one or make your own. That will be up to you and your needs.

IFAK Content:

1. Knowledge

2. Nitrile Gloves

3. Gauze/Maxi pads

4. Tourniquet

5. Combat Gauze (Quickclot Gauze)

6. Chest Seal

7. Trauma Shears

8. Sharpie

9. Elastic Bandage/Coban

10. Tape

11. Decompression Needle? If you have the training

Breaking it down:

1. Knowledge and willingness to act, we will cover this later in its own section.

2. Nitrile Gloves, we need to keep the wound clean and isolate yourself from bodily fluids.

3. Gauze/Maxi pads, most of the time this will be the first thing to go on the wound.

4. There are a few types of tourniquets (CAT gen7, SOF, RATS, SWAT, and maybe a bandanna). The CAT7 is the best general tourniquet but that does not mean that the others don’t have their place also. The RATS tourniquet can be threaded into some rifle slings or could be threaded along the side of your belt. Many of us wear belts, and that's a great way to always have it with us. A RATS would work good on smaller framed people, like kids and seniors. The SWAT is elastic and can be used were a CAT7 can’t be placed, like a junction bleed.

• RATS - https://www.readyman.com/collections/rats-tourniquets/products/rats-gen-2-black

• CAT GEN7 - https://www.rescue-essentials.com/combat-application-tourniquet-cat-gen-7/

• SWAT - https://swat-t.com/

• SOF - https://softourniquet.com/

1. Combat Gauze (Quickclot gauze) is a gauze that has a chemical product impregnated in them that will coagulate blood. There are a few products for this (Quickclot, Celox, Chitogauze, Xstat, and Xgauze).

• Quickclot comes in either a gauze or granular, choose the gauze. Quickclot has the best results in testing and is the most used.

• Celox and Chitogauze are both derived from shellfish, so if you have shellfish allergies this is not an option. Well not so fast, if you are on blood thinners, Celox has shown to stop these bleeds. Talk to your doctor to see if this is an option for you.

• Xstat and Xgauze both require a prescription and are expensive to buy. Is it worth the time and expense to get it? YES, if you have an arterial bleed in the groin a tourniquet or just applying pressure will not stop it. Xstat is a syringe with small sponges that you inject into the wound and then apply pressure for 3-5 minutes. It is the only product to be shown to stop these bleeds. Xstat is NOT TO BE USED IN THE CHEST OR STOMACH AREA, ONLY THE GROIN AREA. Xgauze is used to pack wounds.

• Quickclot - https://quikclot.com/

• Celox - https://www.celoxmedical.com/cx-product/celox-rapid/

• Chitogauze - https://www.narescue.com/chitogauze-xr2-pro-hemostatic-bandage.html

• Xstat - https://www.revmedx.com/

2. Chest Seals. I use Hyfin vent twin pac. You need one for the front and maybe the back if there is an exit wound.

• https://www.narescue.com/hyfin-vent-compact-chest-seal-twin-pack.html

3. Trauma Shears, to remove clothing to gain access to the wound.

4. Sharpie marker, for writing vital information on the victim and tourniquet.

5. Elastic Bandage (Coban), for securing the gauze and splint ACE bandage. I use Coban.

6. Tape, for securing gauze and splint.

7. Decompression Needle

Knowledge and Willingness to Act

Knowledge and a willingness to help others is imperative. How many of you have seen news reports where no one knows what to do? Or they just walk by, as someone is hurt and needs assistance. It’s not in my nature to just walk by and not help someone in need, and most likely since you are reading this, you are the same way.

Now where do we start? We have a kit and an injured person; now what?

We are going to start with the acronym M.A.R.C.H.

• M. - Massive Hemorrhaging

• A. – Airway

• R. – Respiration

• C. – Circulation

• H. - Hypothermia/Head Injuries

Massive Hemorrhaging (bleeding).

Apply direct pressure. If their blood is squirting or very heavy bleeding, then use a tourniquet first. This is a sign of an arteriole bleed. Direct pressure, packing the wound, and elevating the wound is what will be done for non-arteriole bleeds.

Airway

You will check to make sure that there is nothing in their mouth, airway is not blocked, and that the throat is not injured.

Respiration

We will check for breathing and for injury to the chest. This is when we would start CPR and apply chest seals if needed.

Circulation

We will recheck the bleeds again, DO NOT REMOVE TOURNIQUETS, this must be done in the hospital. Check for pulse in different parts of the body, check blood pressure, and start an IV (paramedics). The pulse and blood pressure are checked because there can be internal bleeding that we cannot see, blood pressure loss or no pulse is a sign of this.

Hypothermia/Head Injuries

We must keep the victim warm and treat for shock. With blood loss, shock is very serious, and must be addressed. First Place the victim in the shock position and keep them warm. Head and Neck injuries must be taken seriously and considered life threatening. When applying pressure to the skull (if there is a fracture) you can push bone into the brain.