First Aid Only 91061, 91059, 91060, 91107, 91106 User Manual

What Everyone Should

Know to Stop Bleeding

After an Injury

THE HARTFORD CONSENSUS

The Joint Committee to Increase Survival from Active Shooter and Intentional
Mass Casualty Events was convened by the American College of Surgeons in
response to the growing number and severity of these events. The committee
met in Hartford Connecticut and has produced a number of documents with rec­ommendations. The documents represent the consensus opinion of a multi-dis­ciplinary committee involving medical groups, the military, the National Security

Council, Homeland Security, the FBI, law enforcement, re rescue, and EMS.

These recommendations have become known as the Hartford Consensus. The
overarching principle of the Hartford Consensus is that no one should die from
uncontrolled bleeding. The Hartford Consensus recommends that all citizens
learn to stop bleeding.

Further information about the Hartford Consensus and bleeding control can be
found on the website: Bleedingcontrol.org

2

SAVE A LIFE:

What Everyone Should Know

to Stop Bleeding After an Injury

Authors:

Peter T. Pons, MD, FACEP

Lenworth Jacobs, MD, MPH, FACS

Acknowledgements:

The authors acknowledge the contributions of Michael Cohen

and James “Brooks” Hart, CMI to the design of this manual.

Some images adapted from Adam Wehrle, EMT-P and NAEMT.

© 2017 American College of Surgeons

CONTENTS

SECTION 1 3

■

Introduction

■

Primary Principles of Trauma Care Response

■

The ABCs of Bleeding

SECTION 2 5

■

Ensure Your Own Safety

SECTION 3 6

■

A – Alert – call 9-1-1

SECTION 4 7

■

B – Bleeding – nd the bleeding injury

SECTION 5 9

■

C – Compress – apply pressure to stop the bleeding by:

■

Covering the wound with a clean cloth and applying

pressure by pushing directly on it with both hands, OR

■

Using a tourniquet, OR

■

Packing (stuff) the wound with gauze or a clean cloth and

then applying pressure with both hands

SECTION 6 13

■

Summary

2

SECTION 1: INTRODUCTION

Welcome to the Stop the Bleed: Bleeding Control for the

Injured information booklet. Injury results from a wide variety

of causes, including accidents or intentional harm, and in a
wide variety of locations, such as your home or workplace.
It is important that as many people as possible survive their
injuries if they sustain trauma.

Uncontrolled bleeding is the number one cause of
preventable death from trauma. The greater the number
of people who know how to control bleeding in an injured
patient, the greater the chances of surviving that injury.
You can help save a life by knowing how to stop bleeding if
someone, including yourself, is injured.

In this booklet, you will learn the various ways to control
bleeding, whether you only have your two hands to use or
whether you have a full trauma rst aid kit available to you.

“Uncontrolled bleeding is the number one

cause of preventable death from trauma.”

3

PRIMARY PRINCIPLES OF
TRAUMA CARE RESPONSE

■

Ensure your own safety

■

The ABCs of Bleeding

■

A – Alert – call 9-1-1

■

B – Bleeding – nd the bleeding injury

■

C – Compress – apply pressure to stop the

bleeding by:

1. Covering the wound with a clean cloth and applying
pressure by pushing directly on it with both hands,

OR

2. Using a tourniquet, OR

3. Packing (stufng) the wound with gauze or a clean
cloth and then applying pressure with both hands.

We will go over each of these points as we go through

this booklet.

A: Alert

4

■

B: Bleeding

■

C: Compress

SECTION 2:

ENSURE YOUR OWN SAFETY

■

Before you offer any help, you must ensure your

own safety!

■

If you become injured, you will not be able to help

the victim

■

Provide care to the injured person if the scene is safe

for you to do so

■

If, at any time, your safety is threatened, attempt to

remove yourself (and the victim if possible) from danger
and nd a safe location

■

Protect yourself from blood-borne infections by wearing

gloves, if available

5

SECTION 3:

ALERT – CALL 9-1-1

A

■

Get help

■

OR

■

■

This will notify emergency medical responders and,

depending on the situation, police ofcers to respond

to the scene

A

Call 9-1-1 yourself,

Tell someone to call

9-1-1

6

SECTION 4:

BLEEDING

B

■

Find the source of bleeding

■

Open or remove the clothing over the wound so you can
clearly see it

■

Look for and identify “life-threatening” bleeding

BA

By removing
clothing, you
will be able to
see injuries
that may have
been hidden
or covered.

7

What is “life-threatening” bleeding?

Blood that is spurting out

of the wound.

Blood that is pooling on

the ground

Bandages that are soaked

with blood

Blood that won’t stop

coming out of the wound

Clothing that is soaked

with blood

Loss of all or part of an

arm or leg

Bleeding in a victim

who is now confused

or unconscious

8

SECTION 5:

COMPRESS

C

KEY POINT: There are a number of methods that
can be used to stop bleeding and they all have one
thing in common – compressing a bleeding blood
vessel in order to stop the bleeding.

■

If you don’t have a trauma rst aid kit:

■

Apply Direct Pressure on the wound

Cover the wound with a clean cloth and apply pressure

by pushing directly on it with both hands (see page 10)

■

If you do have a trauma rst aid kit:

■

For life-threatening bleeding from an arm or leg and

a tourniquet is available:

Apply the tourniquet (see page 11)

C

■

For life-threatening bleeding from an arm or leg and

a tourniquet is NOT available OR for bleeding from
the neck, shoulder or groin:

Pack (stuff) the wound with a bleeding control (also
called a hemostatic) gauze, plain gauze, or a clean cloth
and then apply pressure with both hands (see page 12)

We will discuss each of these actions in more detail in the

next few pages.

9

DIRECT PRESSURE ON A WOUND

1. Take any clean

cloth (e.g. shirt)

and cover the
wound

2. If the wound is

large and deep,

try to “stuff” the
cloth down into
the wound

3. Apply continuous

pressure with

both hands

directly on top

of the bleeding

wound

10

4. Push down as

hard as you can

5. Hold pressure to

stop bleeding.

Continue pressure
until relieved

by medical

responders

APPLYING A TOURNIQUET

If you do have a trauma rst aid kit:

For life-threatening bleeding from an arm or leg and a
tourniquet is available:

■

Apply the tourniquet

1. Wrap the tourniquet around the bleeding arm or leg about

2 to 3 inches above the bleeding site (be sure NOT to place
the tourniquet onto a joint – go above the joint if necessary)

2. Pull the free end of the

tourniquet to make it as

tight as possible and

3. Twist or wind the

windlass until bleeding

stops

secure the free end

4. Secure the windlass to

keep the tourniquet tight

5. Note the time the

tourniquet was applied

Note: A tourniquet will cause pain but it is necessary to
stop life-threatening bleeding.

11

WOUND PACKING AND DIRECT PRESSURE

If you do have a trauma rst aid kit:

For life-threatening bleeding from an arm or leg and a
tourniquet is NOT available

OR

For life-threatening bleeding from the neck, shoulder or groin:

■

Pack (stuff) the wound with bleeding control gauze (also

called hemostatic gauze), plain gauze, or a clean cloth
and then apply pressure with both hands.

1. Open the clothing over the

bleeding wound

2. Wipe away any pooled blood

12

3. Pack (stuff) the wound with

bleeding control gauze
(preferred), plain gauze, or
clean cloth.

4. Apply steady pressure with

both hands directly on top of
the bleeding wound

5. Push down as hard as you can

6. Hold pressure to stop bleeding.

Continue pressure until relieved

by medical responders.

SECTION 6: SUMMARY

Assure your safety

Look for Life-Threatening Bleeding

NO YES

■

Use any clean cloth

■

Apply steady direct

Is a Trauma First

Aid Kit available ?

Where is the wound?

pressure directly on
the wound

Arm or leg

neck, shoulder,

groin

Is tourniquet available?

■

Pack the wound
with bleeding con­trol (hemostatic)

gauze (preferred),
any gauze, or

clean cloth

■

Apply steady
direct pressure

■

Apply above the
bleeding site

■

Tighten until the

bleeding stops

NOYES

13

The only thing more tragic than a

death from bleeding…

IS A DEATH THAT COULD

HAVE BEEN PREVENTED.

The ‘Stop the Bleed’ campaign was initiated by a federal interagency workgroup convened by the National
Security Council Staff, The White House. The purpose of the campaign is to build national resilience by
better preparing the public to save lives by raising awareness of basic actions to stop life threatening
bleeding following everyday emergencies and man-made and natural disasters. Advances made by military
medicine and research in hemorrhage control during the wars in Afghanistan and Iraq have informed the

work of this initiative which exemplies translation of knowledge back to the homeland to the benet of the

general public. ‘Stop the Bleed’ is a registered service mark of the Department of the Defense.

Use of the equipment and the training does not guarantee that all bleeding will be stopped or that all lives
will be saved.

© 2017 American College of Surgeons