Stop the Bleed – Save a Life

Reduce your community’s risk by training citizens how to control bleeding


By Robert R. Rielage, CFO, EFO, FIFireE

Is there any doubt fire and EMS services in the United States are on the frontline of every mass casualty incident? From a pickup truck striking a crowd of pedestrians in New York City, a mass shooting in Las Vegas or a motor vehicle crash involving a bus full of young hockey players in Canada's Saskatchewan province, fire and EMS services respond and begins triage, treatment and transport of the viable victims. But what if, prior to our arrival, average citizens were able to begin a lifesaving assessment on bleeding control, just as they are taught about CPR? Enter a program designed to do just that: “Stop the Bleed – Save a Life.”

My department recently hosted an introduction of this program to approximately 20 area fire departments. Our instructor was a physician from the University of Cincinnati’s Medical Center, but, as we learned, anyone holding an EMT certificate or above can act as an instructor for the program.

The object of the Stop the Bleed program is to train enough citizens across the country who, when presented with a trauma incident whether at work, home at a motor crash or mass casualty, can provide immediate first aid. (Photo/USAF)
The object of the Stop the Bleed program is to train enough citizens across the country who, when presented with a trauma incident whether at work, home at a motor crash or mass casualty, can provide immediate first aid. (Photo/USAF)

What Stop the Bleed teaches citizens

Stop the Bleed is an educational program that is the result of a cooperative effort of four highly respected groups: The Hartford Consensus, the American College of Surgeons Committee on Trauma, the Committee on Tactical Combat Casualty Care and the National Association of Emergency Medical Technicians.

This citizen-based initiative focuses on trained individuals acting as immediate responders that can:

  1. Immediately respond to bleeding.
  2. Recognize life-threatening bleeding.
  3. Use appropriate methods to stop the bleeding.

These principles of immediate response instruct the citizen to ensure their own safety and then remember the ABCs of the Stop the Bleed training:

  1. Alert the professionals by calling 911.
  2. Bleeding – find the bleeding injury.
  3. Compress – apply pressure using any or all of three options:
  • Direct pressure using a clean cloth and pressure using both hands.
  • Using a tourniquet.
  • Packing the wound with gauze or clean cloth, filling the wound and then applying direct pressure.

The approximately two-hour presentation then discusses these three methods of bleeding control, including time for citizens to practice all three methods on training aids, and ask questions as they practice.

One of the most frequently asked questions was about the application of a tourniquet. There was a time, not that long ago, when the use of a tourniquet meant risking permanent damage to the patient’s extremity, and would almost certainly result in the amputation of that limb. Now, however, with advanced life support in the field and the recognition that such a patient needs to be at a trauma center within the “Golden Hour,” the proper use of a tourniquet doesn’t mean the dire loss of the limb – in fact, in most cases, it’s a preferred method of bleeding control.

Obviously, the object of the program is to train enough citizens across the country who, when presented with a trauma incident whether at work, home at a motor crash or mass casualty, can provide immediate first aid, just the same as a citizen starting CPR prior to the arrival of first responders, thus giving a victim a better chance of survival.

Educating citizens across the community

Several firefighter and paramedics discussed the possibilities after the presentation, such as how expanding the program to local schools would be beneficial. While we would hope to get an adequate number of interested teachers and administrators at each school, I cautioned that we need to remember that, just like CPR, this training may not be for everyone, especially the faint of heart.

A suggestion from one of the tactical medics was to work through the athletic trainers at the high schools, and for them to use the Stop the Bleed program to augment their existing training. Having the athletic trainers onboard, could also help introduce the concept throughout the school system. We expect to have a plan in place for implementation of the program corresponding to the start of the new school year this fall.

Using the schools as a springboard, the next logical step would be to offer this training to our businesses and industries through the local Chamber of Commerce, and then to the general public as an option following CPR/AED training. It could also become one of the training sessions for our Citizens’ Fire Academy.

Regardless of how we eventually decide to offer the Stop the Bleed program, the brief presentation at our fire training facility was a catalyst that gave us a new tool in our community risk reduction efforts that could save a life or many lives in the future. I hope you might use this article to spark an interest in your own community.

Learn more about Stop the Bleed – Save a Life.

In the meantime, stay safe!

About the author

Chief Robert R. Rielage, CFO, EFO, FIFireE, is the former Ohio fire marshal and has been a chief officer in several departments for more than 30 years. A graduate of the Kennedy School's Program for Senior Executives in State and Local Government at Harvard University, Rielage holds a master's degree in public administration from Norwich University and is a past-president of the Institution of Fire Engineers — USA Branch. Chief Rielage can be reached at Robert.Rielage@FireRescue1.com.

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