Friday, December 06, 2019

Miscellany: Stop the Bleed class notes


I took a free hour-long Stop the Bleed "Bleeding Control (B-CON) Basic" class at Osceola Regional Medical Center, taught by Michelle Rud, RN. The curriculum was developed after Sandy Hook by the American College of Surgeons and government agencies, but the bleeding control techniques we learned are much more likely to be used in an everyday accident than a mass murder.

NOTES

Is the scene safe? Don't be another patient by putting yourself at risk. You may also need to move the victim to safety or wear protective gear like gloves.

Call 911. And point to someone else and tell them to call 911. Better to have a half-dozen people call for the same incident than having no one get through.

Signs of life-threatening bleeding: Is blood spurting, pooling, or soaking through clothes? Is the patient confused or unconscious? Has the patient lost all or part of a hand, arm, or leg?

If it looks bad, stop the bleeding: Get patient on the ground, and apply direct pressure with clean clothing / use a tourniquet / pack the wound with gauze or clothing. Note that AEDs often have a trauma kit inside.

DIRECT PRESSURE

Once you apply, you cannot lift off the wound. Direct pressure is exhausting and ties up your hands - you may need to switch off with another person to keep holding pressure. Another option is to put your knee on the wound. Generally, direct pressure is more available and more reliable than a pressure dressing, but pressure dressings allow you to move the patient.

When pressing or packing, don't use denim jeans and don't use comforters. A T-shirt is usually okay. It doesn't have to be clean - the hospital will shoot them full of antibiotics if they make it.

TOURNIQUET

Don't put it over a joint. It should be tight enough to stop the bleeding. The limb will likely feel tingly and start to become purple.

WOUND PACKING

Don't ever take the packing material out. QuikClot is nice, but regular gauze works. Form a ball of material to protect your finger from sharp broken bones, and push in deep, keeping pressure while working in the material. Once you have a good wad built over top, press on that until help arrives.


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